Some women with breast cancer may be better off having less invasive and less toxic treatments. “But right now, we can’t identify them very well,” says breast cancer specialist Melanie Royce, MD, PhD. “The question is, how can we identify those patients so that we do not treat them with the full spectrum of our available therapies and thereby spare them the toxicities of treatment?”
Clinical trials can answer these big, important questions about cancer treatment but they can be costly and difficult to manage. So last year the National Cancer Institute overhauled its clinical trials systems. “The NCI is trying to streamline and organize clinical trials systematically so that they can move science and clinical medicine forward faster and more efficiently,” says Richard Lauer, MD, FACP. Lauer and Royce were recently named to national task forces under the NCI’s new clinical trials structure.
The new structure consolidated the nine adult cancer clinical trials groups into four groups. It also centralized functions that all of them use. Each group’s steering committee determines the scientific value and feasibility of every clinical trial in the United States under its authority. The steering committees use task forces for guidance and advice. “The task forces’ role is to percolate ideas — and maybe answers or hypotheses — and then to advise the Steering Committee as requested or when appropriate,” says Royce. She sits on the Breast Oncology Locally-Advanced Disease, or BOLD, task force. Lauer, who has published clinical research papers on kidney cancers, sits on the Renal Cancer task force.
The task forces bring together many different types of physicians and scientists. They include medical oncologists, radiation oncologists, surgeons, pathologists and statisticians. Lauer and Royce are both medical oncologists who also bring the point of view of running clinical trials. Lauer is Chief Medical Officer at the UNM Cancer Center. Royce is principal investigator for the Minority/Underserved NCI National Community Oncology Research Program grant that the UNM Cancer Center won last year. “The science may be great,” says Royce of potential clinical trials. “But the technology has to be there to make it happen.”
Lauer agrees. “I think that there are new sciences and new technologies that are coming to bear and our understanding of cancer is better,” he says. “We’re trying to figure out how to integrate these new technologies into the treatment of kidney and other cancers.”
Richard Lauer, MD, FACP, is a Professor in the Division of Hematology/Oncology in the UNM Department of Internal Medicine at the UNM School of Medicine. He is the Chief Medical Officer at the UNM Cancer Center and is the Maralyn S. Budke Endowed Professor in Cancer Care Delivery. Trained at New York Medical College and Indiana University, Dr. Lauer is an expert in the treatment of genitourinary cancers and the delivery of high quality, integrated cancer care in academic settings, blending comprehensive cancer diagnosis and treatment with clinical research. He has served as principal investigator for several clinical trials and is responsible for all clinical aspects of the UNM Cancer Center’s operations.
Melanie E. Royce MD, PhD, is a tenured Professor in the Department of Internal Medicine, Division of Hematology/Oncology at the UNM Cancer Center. She received her PhD and MD degrees at the University of Cincinnati in Cincinnati, Ohio. She completed her residency in Internal Medicine at Yale University School of Medicine in New Haven, Connecticut, and a Medical Oncology fellowship at The University of Texas M.D. Anderson Cancer Center in Houston, Texas. Dr. Royce is the Director of the UNM Cancer Center Multidisciplinary Breast Cancer Clinic and Programs. She cares for breast cancer patients and oversees a number of clinical trials in breast cancer. She collaborates with a number of UNM Cancer Center basic and population scientists to understand and overcome some of the disparities in breast cancer seen among our unique New Mexico population.
On March 1, 2014, after several years of extensive consultation and coordination with many stakeholders, NCI transformed its longstanding Cooperative Group program into the new National Clinical Trials Network (NCTN). Guided by recommendations in a 2010 Institute of Medicine (IOM) report, the design and implementation of the NCTN incorporates feedback from Cooperative Group investigators, NCI Comprehensive Cancer Center directors, several NCI working groups, leading cancer researchers, industry representatives, and patient advocates.
Learn more at http://ctep.cancer.gov/initiativesPrograms/nctn.htm
The UNM Cancer Center is the Official Cancer Center of New Mexico and the only National Cancer Institute-designated Cancer Center in the state. One of just 68 premier NCI-Designated Cancer Centers nationwide, the UNM Cancer Center is recognized for its scientific excellence; contributions to cancer research; delivery of high quality, state of the art cancer diagnosis and treatment to all New Mexicans; and its community outreach programs statewide. Annual federal and private funding of more than $72 million supports the UNM Cancer Center’s research programs. The UNM Cancer Center treats more than 60 percent of the adults and virtually all of the children in New Mexico affected by cancer, from every county in the state. It is home to New Mexico’s largest team of board-certified oncology physicians and research scientists, representing every cancer specialty and hailing from prestigious institutions such as M.D. Anderson Cancer Center, Johns Hopkins University, and the Mayo Clinic. Through its partnership with Memorial Medical Center in Las Cruces, the UNM Cancer Center brings world-class cancer care to the southern part of the state; its collaborative clinical programs in Santa Fe and Farmington serve northern New Mexico and it is developing new collaborative programs in Alamogordo and in Roswell/Carlsbad. The UNM Cancer Center also supports several community outreach programs to make cancer screening, diagnosis and treatment available to every New Mexican. Learn more at www.cancer.unm.edu.