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Clinical Adjustments in Lung Cancer

Beginning a clinical trial means being ready to adjust to new and potentially unknown side-effects, and requires a readiness to roll with the changes. For many lung cancer patients, a clinical trial may be a last-resort, a final attempt to find a life-extending treatment after all other options have failed. For others, it may be a way to get in on the ground floor for an experimental drug that targets a specific mutation for which there are no commercially available options. And there are those patients who simply want their experience to mean something to future patients when their own prospects are, at best, limited.

Helping advance research

Whatever the motivations for the participating patients, clinical trials are an essential part of the research and development process for new lung cancer treatments. Over the last two decades, more advancements have occurred in lung cancer research than in all of preceding human history combined. With the growing understanding of cancer genetics made possible through scientific advances in DNA analysis, gene splicing, molecular technology, and a host of cross-disciplines ranging from medical science to computer technology, this has been a sort of Golden Age of new treatments.

As such, clinical trials today are often a smart way for qualifying patients to gain access to the latest innovations. For prior generations, there was a sense that only the most desperate patients turned to clinical trials for help. They may have been last-ditch efforts for those who saw the process as nothing more than guinea pigs in a lab. But the reality was that participating patients were often the true heroes of research, opening pathways for scientists that have lead to the targeted therapies and immunotherapies that are now making headlines virtually every month.

Qualifiying for a clinical trial

While clinical trials are usually reserved for advanced cancer patients, it is in every patient’s interest to inquire about the options when he or she is initially diagnosed. Because new trials become available quite frequently, patients at every stage should check the clinical trial database or one of the numerous non-profit and government resources available online.

Often the first step toward qualifying for a clinical trial is molecular testing. There are a small number of labs that do the genetic analysis for most hospitals and research centers required to qualify patients for the newest therapies. This means that in addition to information needed for clinical trials, these genetic tests also allow oncologists to match patients with the best available commercial therapies. And since cancer treatment is moving more toward a focus on the underlying genetic markers of a cancer rather than its area of origin in the body, such an analysis is often done shortly after the initial diagnosis.

Genetic analysis can be performed either on a tissue sample or from a liquid biopsy. There are pros and cons to each process. The liquid biopsy, for example, is the easiest to perform — it only requires a simple blood draw that takes just a few minutes of the patient’s time — but it is often less accurate than a tissue biopsy. Of course, even a tissue sample might provide false-negatives or incomplete results. Because of this, it is important that the area being biopsied is able to provide a suitable amount of tissue with minimal risk to the patient.

Weighing the options with an oncologist will help determine the appropriate course. Even if a biopsy has already been performed, sometimes it is in a patient’s best interest to have a new analysis done for various reasons. Over time, new mutations become treatable as the available research data grows. And sometimes, after months or years of treatment, new mutations will develop in a patient’s cancer that will allow for new or innovative treatments.

Weighing the options

Perhaps surprisingly, there are ongoing clinical trials with proven, commercially available drugs. In these trials, they are often being tested in conjunction with other drugs designed to enhance the process by which they work with the hope that they will prove effective for a wider range of patients. And even with the more experimental drugs, patients are monitored very closely to ensure that they are receiving the best available care. Another benefit to clinical trials is that the cost is generally covered by the sponsoring pharmaceutical company or research institution, including the costs of tests specifically required for the trial beyond the normal expectations of treatment that insurance companies approve.

Becoming part of something bigger

When patients are armed with the best data about themselves, their range of treatment options is able to expand. While surgery, radiation, and chemotherapy are still the gold standard of care for most lung cancer patients, clinical trials have opened the doors to the latest targeted and immunotherapies for thousands of people. Because it can take many years for promising new drugs to work through the testing and approval system, the best options available for some patients may only be through clinical trials. And by agreeing to participate in trials, patients become part of something much bigger, bringing science closer to finding better treatments and, ultimately, more cures.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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