Kamal Saini, MBBS, MD, MRCP (UK)
DM (Med Onc), Executive Medical Director,
Ken Morrison PhD PMP
Executive Director, Global Head Operational Strategy & Planning Oncology, Labcorp Oncology
Cancer patients are accessing unique opportunities for individualised care through participation in ground-breaking clinical trials.
Taking part in clinical trials is increasingly being seen as a critical step in offering greater individualisation of care for cancer patients.
With one in two people in the UK likely to have cancer at some point in their lives, the latest NHS Long Term Plan aims to deliver dramatic improvements in ways to diagnose and treat cancer.
While this includes screening programmes, earlier diagnosis, investing in cutting edge treatments and technologies and highly-personalised therapies for patients, clinical research as a care option will be a critical element in evolving cancer care and introduction of innovative diagnostic and therapeutic options which will provide opportunity for earlier cancer diagnosis, and more personalised therapies that manage the individual patients’ cancer.
Providing care through clinical trials
Even though the proportion of cancer patients participating in clinical trials is higher in the UK than in most other countries, there is significant scope for further improvement. This can be achieved by increasing the availability of suitable cancer trials in the UK, improved patient access in rural areas and lower socioeconomic groups, and creating awareness among patient advocacy groups and healthcare providers within the NHS.
Medical oncologist Dr Kamal Saini says treatments have moved away from a one-size-fits-all approach to greater precision and individualised treatments, but there are opportunities to advance that further.
“We’re progressing beyond treating patients in broad groups towards delivering more precise and personalised therapies. Such individualisation is accelerating, especially with the development of cell and gene therapies for cancer. But there is a gap between what is possible for selected patients with cutting edge science and what can be delivered at scale through our existing clinical infrastructure,” says Dr Saini, a practicing locum medical oncologist at the NHS, and Executive Medical Director at Labcorp, which operates one of the largest clinical trial services and clinical laboratory networks in the world. “Doctors, researchers, planners, regulators and industry are seeking to address that gap. But one of the biggest challenges for cancer researchers today is how to fully realise the potential of precision medicine which involves getting the right treatment to the right cancer patient at the right time.”
We’re progressing beyond treating patients in broad groups towards delivering more precise and personalised therapies.
Finding appropriate UK clinical trials
Dr Ken Morrison, Global Head for Operational Strategy and Planning at Labcorp, says: “What we are seeing is an evolution in cancer trial design that is moving from broad categorisation – e.g. “breast cancer” – to a very precise profiling of an individual patient’s breast cancer based on the individual cancer disease genetic mutations and protein expression, informing treatment options that data shows to be most effective.
“We provide both the diagnostic assessment and characterisation of an individual patient’s cancer and then access to suitable clinical trials options in partnership with the cancer patient’s healthcare professional.”
Technological advances – such as artificial intelligence, big data, and digital biomarkers – are being embraced by academic centres across the UK, to offer detailed individualised reports about a patient’s cancer, and how they are responding or likely to respond to treatments.
The science is advancing. Immuno-oncology drugs have become the ‘backbone of treatment for cancer’ but newer mechanisms, like mRNA-based vaccines for individual patients and CAR-T and cell and gene therapy solutions are also being developed.
“We are at the cusp of great acceleration in adoption of novel therapies” says Dr Saini. “There will be rapid improvement in outcomes for cancer patients and clinical trials are needed to develop and implement the next generation of cancer therapies.”
While clinical trials are increasingly attractive as a treatment option, assessing patients for their suitability, recruiting them to participate, partnering with specialist cancer centres across the UK and focusing on patients’ needs through clinical trials at the point of care remain critical in establishing the infrastructure for adoption of these innovative therapies in the NHS.