The battle: CCCN’s research role in the enduring war against cancer

By Drs. Nicholas J. Vogelzang and Fadi Braiteh

Friday, May 19, 2017 | 10:35 a.m.

Call Comprehensive Cancer Centers of Nevada what you may in the war effort against cancer: A general. A lieutenant. A soldier.

Regardless of the label or analogy, we are truly members of an army — an army of cancer researchers.

We have a tough enemy — not just one cancer, but more than 250 cancers. Each one of them is unique, and made more unique by the genetics of the individual in whom the cancer occurred. Whereas in years past, we’d only be able to focus on certain common cancers, here in 2017, we are able to target and develop personalized treatment plans for virtually every cancer, be it common or rare.

Rare types of bladder cancer, lung cancer — you name it — that used to be hiding under the rubric of “cancer” are now getting more and more attention and, as a result, more success. There has been a fundamental shift — industry-wide — in the way that we’re going after very rare or “orphan” cancers.

Research is persevering over the challenges that face our field. Clinical trials are heavily regulated by the Food and Drug Administration (FDA), scrutinized by institutional review boards, denied by some insurance companies, influenced by politics, based off the evidence of laboratory research discoveries and much more. With the efforts of thousands of professionals and potentially thousands of patients nationwide enrolling in different phases of a single study, the process and resulting drugs are often costly.

But, at the end of the day, our patients’ vitality is 100 percent worth it. And it’s important to recognize all the organizations putting forth their best effort in enhancing research efforts across the nation. The “army” fighting this battle is a huge entity. For example, pharmaceutical companies are investing the time, energy and capital to develop new drugs. Also, fellow organizations like the Mayo Clinic, MD Anderson Cancer Center, Memorial Sloan Kettering Cancer Center and Dana Farber Cancer Institute — among many others — should be recognized for their strengths and contributions to cancer treatment, just as we are. We enjoy the friendly competition in developing treatments at the same time as these respected organizations because our Nevada patients are experiencing immediate benefit.

We see ourselves as the Las Vegas barrack of the army against cancer. CCCN is an affiliate of The US Oncology Network and participates in more than 170 Phase I, Phase II and Phase III clinical research studies each year. To date, the physician-owned practice has played a role in developing more than 60 FDA-approved cancer therapies. CCCN’s research results have been presented and published in hundreds of manuscripts and before several congresses throughout the years.

After building such a robust and sustainable clinical research program, pharmaceutical companies are approaching CCCN to be among the first to activate clinical trials — they know the practice can typically open the trials faster and ultimately start treating patients quicker. CCCN has hosted clinical trials for decades and has worked with companies throughout the world on bringing the most effective cancer treatments available to Southern Nevada.

Perhaps most notably — we were engaged early in immunotherapy trials — a type of treatment that equips the body’s immune system to strategically fight destructive cancerous cells — well before such drugs became a staple. CCCN was a leader in the United States spearheading research on Provenge, which was the first immunotherapy utilized to treat prostate cancer. In 2010, the FDA approved the use of Provenge and CCCN administered the first treatment in Nevada. Subsequently, more than 300 CCCN patients have received Provenge, traveling from Montana, Idaho, Arizona and states throughout the Western region to be on that drug.

Drugs referred to as “check point inhibitors” — such as nivolumab, pembrolzumab druvalumab and avlumab are all commercially available today… and CCCN played a part in developing them.

With each success, we are endlessly grateful for our patients who are willing to trust us with their health. And, in order to preserve the health of the next generation, we must do even more.

Additionally — across the oncology field — we still have a challenge regarding patients’ literacy of clinical trials and their understanding of the added benefits of participating in clinical trials. Many patients don’t fully grasp how important research could be for them personally. They many not understand the many safeguards in place around clinical trial participation nor do all understand unique molecular characteristics that must be met to qualify for trials. Sadly these barriers mean that only 3 percent of patients enter clinical trials.

As we reflect on recent CCCN research milestones, we’re ready for the journey ahead. No matter the individual battle our patients may face, we’re always seeking the absolute best way forward, no matter if that solution exists already or may be just over the horizon.

Nicholas J. Vogelzang, MD, FASCO, FACP, is a medical oncologist. Fadi Braiteh, MD, is a medical oncologist and director of the Translational Oncology Program Phase I and GI Malignancies Program for Comprehensive Cancer Centers of Nevada.