Clinical Trials Transform Cancer Care: Patient Outcomes and Precision Medicine Advance

Clinical trials are providing new treatment options for cancer patients, with some individuals achieving long-term survival even with advanced disease. Precision medicine programs are also expanding access to these trials by identifying patients with specific tumor mutations, a shift that is reshaping oncology care.

A 74-year-old patient with inoperable stage 4 pancreatic cancer enrolled in a clinical trial at Roswell Park Comprehensive Cancer Center in late 2019. After four months of treatment that included infusions every two weeks and home chemotherapy, his tumor had shrunk by 35%, and his cancer antigen (CA 19-9) level decreased from 11,000 to less than 34. After two years on the trial, he continued chemotherapy closer to home for another two years without disease progression. Five years after his initial diagnosis, surgery removed his spleen and part of his pancreas, revealing only a benign cyst where the tumor had been. He has been cancer-free for more than six years.

This patient’s outcome illustrates how clinical trials can offer advanced therapies not available through standard care. “Since standard-of-care therapies usually cannot cure advanced stage pancreatic cancer, I encourage all patients with pancreatic cancer to look for clinical trial options before making any treatment decision,” said a co-leader of Roswell Park’s gastrointestinal clinical disease team.

Meanwhile, Kaiser Permanente’s Genomic Oncology program has tested more than 33,000 patients’ tumors with next-generation sequencing (NGS) since 2017. The program, now one of the largest community-based precision oncology programs in the U.S., has grown from testing 40-50 patients per month initially to about 550 patients monthly. A recent analysis found that 21.7% of patients had genomic alterations that could guide treatment decisions, and 14% had findings that could qualify them for a clinical trial.

More than 40% of new cancer drugs approved by the U.S. Food and Drug Administration are now precision therapies that target specific mutations in a patient’s tumor. This shift means patients with different cancer types may enroll in the same clinical trial if they share the same tumor mutations. “Oncology clinical trials today are very different than what they used to be,” noted the medical director of the Kaiser Permanente Oncology Clinical Trials Program. The program enables enrollment in large, significant clinical trials and can open new trials at Kaiser Permanente if a patient’s mutation qualifies them for a trial not currently available there.

Clinical trials are increasingly seen not as a last resort but as a way to access the latest advances in cancer care. “Every treatment we use today exists because patients participated in clinical trials,” stated a medical director of radiation oncology at City of Hope’s Orange County. The expansion of precision medicine and genomic testing is directly linked to the growth of these trials, which continue to shape the standard of care for future patients.