HJBR Nov/Dec 2023

HEALTHCARE JOURNAL OF BATON ROUGE I  NOV / DEC 2023 55 Victor Lin, MD, PhD Medical Oncologist Mary Bird Perkins Cancer Center also overall quality of life. There is renewed interest across the board in ensuring the patients participat- ing in studies accurately reflect the overall population. Unfortunately, there is dispro- portionately low enrollment of patients of minority backgrounds. Barriers to their trial participation may include eligibility criteria that disfavor these patients, such as medical comorbidities; limited accessibility to study sites; logistical challenges, like transporta- tion or inability to take time off work; and distrust of the healthcare system and clinical research in particular. In Louisiana, the lack of available studies remains the biggest bar- rier; if there are no trials, the other hurdles are irrelevant. However, if we can make can- cer clinical trials accessible to more Loui- sianans, we are uniquely positioned to ad- dress disparities through the commitment and support of patients, healthcare organi- zations, and industry sponsors. Cancer clinical trials are how cancer care evolves Recorded examples of cancer treatments date as far back as ancient Egypt. In the past two centuries, we have gone from only sur- gical options to adding radiotherapy and chemotherapy. Innovations have continued at a breathtaking pace over the past 30 years, thanks in large part to conducting cancer clinical trials. Some of these recent breakthroughs have completely revolutionized the care of cancer. Targeted therapies combined with next-generation sequencing have proven to be more effective and less toxic than con- ventional chemotherapy in many instances, and more targets and drugs continue to be developed every day. Radioligand therapies deliver radiation to specific targets, reduc- ing both systemic side effects and toxici- ties from conventional radiation. Immuno- therapies harness the body’s own immune system to fight cancer and have proven to be effective in a variety of cancer types for which prior therapies were ineffective. Ex- tensions of this concept have resulted in the development of chimeric antigen receptor T cell (CAR-T) and bispecific T cell engager (BiTE) therapies, many of which are on the drug development horizon. None of this would be possible without cancer clinical trials. It is imperative that we bring more access to these studies right here so that more Louisianans can have a chance at ten more weeks. n REFERENCES Siegel, R.L.; Miller, K.D.; Wagle, N.S.; Jeal, A. “Can- cer Statistics, 2023.” CA: A Cancer Journal for Clinicians 73, Issue 1 (Jan. 12, 2023). Accessed through American Cancer Society Journals. https://acsjournals.onlinelibrary.wiley.com/doi/ full/10.3322/caac.21763 Ailawadhi, S.; Advani, P.; Yang, D.; et al. “Im- pact of access to NIC- and NCCN-designat- ed cancer centers on outcomes for multiple myeloma patients: A SEER registry analysis.” Cancer 122, Issue 4 (Nov. 13, 2015). Accessed through American Cancer Society Journals. https://acsjournals.onlinelibrary.wiley.com/doi/ full/10.1002/cncr.29771 Victor Lin,MD,PhD, is amedical oncologist and also provides leadership for Mary Bird Perkins Cancer Center’s clinical research, genetics, and precision medicine programs. Lin completed a Bachelor of Science in biochemistry with honors at Brown Uni- versity before training in the NIH-supportedMedical ScientistTraining Program (MSTP) at the University ofAlabama at Birmingham,receiving both anMD and a PhD in cell biology.After training,he joined the UAB Department of Medicine as an instructor in the Divi- sion of Hematology andOncology with a clinical focus on lung cancer and sarcoma and a research focus in precision oncology. He also served as the associate director of the UABMolecularTumor Board and was a member of the UAB MSTPAdvisory Committee. can be intense, and these protocols require more attention to detail than other clini- cal trials. There is often more sampling of blood and other biospecimens to assess for potential toxicities and to understand the pharmacokinetic and pharmacodynamic properties of the agent(s). Because patients are usually required to return for frequent visits to the trial site, their ability to partici- pate may be limited by geographic location or means for relocating accordingly. To conduct these studies, a center must make substantial investments in human re- sources and facilities to build the appropri- ate infrastructure. It also needs physicians and staff with appropriate experience to run the trials. Furthermore, it must have access to a broad population of patients to screen for potential enrollment. If these challenges can be surmounted, the potential benefits for patients are immeasurable. Overcoming disparities in cancer clinical trials Louisiana is an area of great need with cancer outcomes that rank amongst the worst in the country, but local availability of Phase 1 cancer trials is extremely limited. Too many patients have had to choose be- tween staying close to home or uprooting their lives to seek the best options for care elsewhere. Expanding access to encompass the region is crucial to improving survivor- ship and lessening the burden of cancer. Do- ing so will increase treatment options and also permit our patients to remain close to home. Convenient options for comprehen- sive care can lessen the financial burden of travel and allow patients to spend more precious time at home with loved ones. This not only improves survival outcomes, but