Transcription:
Immunotherapy and Clinical Trials

Melanie Cole (Host):  Cancer Treatment Centers of America® (CTCA) is committed to bringing you new and innovative investigational cancer treatment options. One way we do this is by participating in cancer research trials and studies. My guest today is Dr. Glenn Weiss. He serves as the Director of the Clinical Research and Phase I and II in Clinical trials at Cancer Treatment Centers of America at Western Regional Medical Center near Phoenix. Welcome to the show, Dr Weiss. Tell the listeners, what is a clinical trial?

Dr. Glenn Weiss (Guest):  Well, first of all, thank you for having me. A clinical trial is an investigation where we are trying to learn some type of information that may either advance science or benefit patients.

Melanie:  So, is this an alternative to standard treatment, is it a secondary treatment or is it something that patients can look to the first time?

Dr. Weiss:  A clinical trial is something that patients can look to from the very first time. There are clinical trials for patients with cancer- who have early-stage disease, and also clinical trials for patients who have advanced and metastatic cancer, and clinical trials may be part of their options along all their whole disease spectrum or any course of their disease and treatment.

Melanie:  Do clinical trials offer a more advanced treatment or just a little bit different- something that is in testing stages?

Dr. Weiss:  Well, since the objective of a clinical trial is to learn something new that might improve or benefit the treatment for the current patients that are being evaluated for that study now or in the future, I would consider a clinical trial as being something that is offering new options for patients. And some of the types of clinical trials that may exist, if they involve a treatment, that can include the standard of care, and sometimes, the clinical trial includes standard care plus something else or an entirely different treatment.

Melanie:  Do patients need to worry if they are involved in a clinical trial that they are not getting that standard of care that you have mentioned?

Dr. Weiss:  All patients that want to participate in clinical trial- go through an informed consent process. So, they are informed about all the risks, potential benefits and the alternatives of participating on that trial. So, the alternatives would be not to participate in the trial and doing what may be standard. The risks would be including anything that is theoretical or possible with the existing treatments, whether or not that’s standard of care treatment or the investigational or experimental treatment. And the benefits may be that if the treatments that they wouldn't otherwise get under the trial are beneficial to them, they wouldn't have access to that treatment or that approach without being a participant on this study.

Melanie:  Tell the listeners, Dr Weiss, what is immunotherapy and how is that involved with clinical trials advancing cancer care?

Dr. Weiss:  There are few types of immunotherapy that are available to patients with certain types of cancer and a certain stage, in particular melanoma. What immunotherapy is, is if you imagine that your body has an alarm system and there is a fire going on and the alarm system goes off and that fire could be set off by an infection. When someone has cancer, their alarm system is not functioning, and what immunotherapy helps do is turn on that alarm system so that their immune system is activated and responds to the call to help fight off the cancer.

Melanie:  That's fascinating. How does it do that?

Dr. Weiss:  So, there are varieties of aspects or methods for immunotherapy to work. Some of the most exciting new treatments, particularly for, let's say, melanoma, that work by immunotherapy. These involve antibodies or certain types of proteins that are developed in the laboratory and they are developed to specifically to block some of the aspects of the immune systems, particularly the T-cells. And when you block those signals, it helps turn on that alarm system to fight the cancer. It doesn't work for everyone and it doesn't work for every single type of cancer but as we proceed with clinical trials and uncover new ways of harnessing this immune system, we are making strides to improve those outcomes and apply it to patients, not just with melanoma but also kidney cancer and certain types of lung cancer.

 Melanie:  How do you manage side effects, if you are dealing with immunotherapy or any type of therapy for cancer care? What do you tell people to expect?

Dr. Weiss:  Well, the types of side effects one can experience really depends on the type of treatment as well as the immunotherapy. So, certain types of standard chemotherapy have their own unique type of side effects -some they are particular or specific to the specific drug that is being used. Then, there are certain types of side-effects one can expect for a class of types of chemotherapy. Immunotherapy, in general, has its own unique side-effect profile. In general, if we are talking about going back to the analogy of an alarm system, so not only do we encounter potential side effects when the alarm system is activated, but if it's over-activated, you then have your immune system attacking sometimes your own body or your own cells and not just the cancer cells. So, the way to deal with those potential side effects is, one, you inform your treatment provider or physician about what's going on, and then, there are medicines that can supress the immune system to calm down that alarm response so that you don't have the side effects that weren’t intended as part of the anti-cancer treatment.

Melanie:  Tell us about some of the clinical trials that may or may not involve immunotherapy that you are doing there in Cancer Treatment Centers of America.

Dr. Weiss:  We have a number of clinical trials available here that involve immunotherapy. Some of them are with immunotherapy drugs by themselves, and we do have a number of studies that are involving immunotherapy along with chemotherapy or targeted anti-cancer therapy. And we have access to additional immunotherapy studies that involve new types of immune-modulating or activating drugs. And our studies are open to patients with advanced cancer, and we have studies specific for certain types of lung cancer, kidney cancer, breast cancer as well as other studies where if a patient has gone through standard treatments and they have advanced cancer, they may be eligible for those studies involving immunotherapy and it's not cancer-specific.

Melanie:  Tell us about the future, Dr Weiss. What does the future hold for immunotherapy research?

Dr. Weiss:  I think the future for immunotherapy research will be that we are not just going to be using one particular drug to help stimulate the immune system or turn on that alarm. For most patients with cancer, it may require more than one type of treatment and that combination will, hopefully, be able to contain the cancer, prevent it from spreading. Hopefully, for some patients, this means long-term control of their disease and potentially no additional therapy after that, which is what we have seen with current drugs that are now commercially available for treating melanoma and certain types of lung cancer.

Melanie:  In just the last few minutes, Dr Weiss, what should people know about clinical trials and immunotherapy at Cancer Treatment Centers of America?

Dr. Weiss:  Patients should know that if they have cancer, particularly advanced cancer, they should give us a call and find out if we may have an answer or treatment that is available to them. We don't just have one study, we have a number of trials, and so, if one study is not an option for them because they don't have the right cancer or they don't have the right prior therapies before going on that trial, we have other options where we may be able to help them.

Melanie:  Thank you so much. You are listening to Managing Cancer with Cancer Treatment Centers of America. For more information, you can go to www.cancercenter.com.  That’s cancercenter.com. This is Melanie Cole. Thanks so much for listening.