UH Seidman Cancer Center one of leading centers for NCI-sponsored trial
Innovations in Cancer - Summer 2017
LISA ROGERS, DO
Medical Director, Neuro-oncology Program, UH Cleveland Medical Center; Professor, Neurology, Case Western Reserve University School of Medicine
A revolutionary clinical trial that targets the genetic pathway of a patient’s tumor is under way at University Hospitals Seidman Cancer Center. This trial, which could transform cancer treatment, is seeking more patients for its Molecular Analysis for Therapy Choice (MATCH) study, sponsored by the National Cancer Institute (NCI).
“Cancer genomics can be considered the ‘holy grail’ of cancer treatment if you can find the particular gene abnormality within a patient’s tumor, and if there is a drug available to target that abnormality,” says neuro-oncologist Lisa Rogers, DO, who has a patient in the trial. “Instead of attacking the tumor with traditional cancer-fighting therapies that can also attack normal cells, we can identify what we need to target and treat the cancer more precisely.”
Raymond Getts has neurofibromatosis type 1 (NF1), a rare genetic disorder in which tumors form on nerves throughout the brain, spine, and body. These predominantly benign tumors can progressively enlarge and may develop into serious malignant cancers. Raymond was referred to Dr. Rogers because of worsening arm and leg weakness due to multiple spinal tumors. Because of the sheer number of tumors, Raymond was not a candidate for surgery. In addition, standard radiation and chemotherapy treatments are not effective for this type of tumor.
But he was an ideal candidate for the MATCH trial. Doctors identified the genetic abnormality in his tumor and matched this with a drug targeting it. Raymond started on daily pills of Trametinib and within weeks, the severe weakness in Raymond’s arms and legs improved and his labored breathing returned to normal. He no longer regularly needs a wheelchair.
“This is a really dramatic success story,” Dr. Rogers says. “For years, we’ve been searching for this type of an approach. The NCI has made this their focus, so that people with previously untreatable tumors can get better.”
The MATCH Trial accepts adults 18 years of age and older with any type of solid tumor or lymphoma that has returned or gotten worse after standard systemic therapy. Patients may also be eligible if, like Raymond, they have a rare type of cancer for which there is no standard treatment. One in every four to five screened patients will have a gene abnormality that makes them eligible.
“Identifying a patient’s cancer genomics for treatment guidance is an approach often used at UH Seidman Cancer Center,” says Christopher Hoimes, MD, Cancer Genomics Program Leader at UH Seidman Cancer Center. “In conjunction with the national genomics labs around the country and our patients’ determination and commitment, we are one of the leading centers of the NCI-MATCH.”
To determine if a patient is eligible for one of the study’s 29 treatment arms, doctors conduct genetic testing on tumor samples. They examine samples to discern whether these tumors contain specific gene abnormalities that can be matched to FDA-approved or investigational drugs or drug combinations being studied in the trial.
“We are specifically interested in patients who are able to withstand being off treatment for a month to six weeks during the genetic testing and selection process,” Dr. Hoimes says. “Patients need to have adequate function of their major organs and be able to carry out light daily physical activities.”
UH Seidman Cancer Center, part of the Case Comprehensive Cancer Center at Case Western Reserve University, is participating in this trial through its membership in the NCI’s National Clinical Trial Network. The study seeks to enroll 5,000 patients for screening nationwide.
Raymond is proud to be part of scientific progress in the field of cancer. Had he not started the MATCH trial, he expects he would have needed full-time assisted care.
“The cool part is that they are now getting down to the specific genes,” Raymond says. “This is how they are going to have to deal with cancer, just like they do with diseases like diabetes.
“Slowly, I’m getting better every day.”