Here's a very brief summary of our experience at the AACR conference
on Molecular Targets and Cancer Therapeutics. As the conference name
suggests these were very technical scientist-to-scientist meetings and
presentations. As such, it was a challenge to integrate patient
perspective into the many excellent conversations we had ... but we
managed to remind:
* of the need to identify biomarkers to predict toxicity -- that it's
important to fail fast in order to concentrate on treatment candidates
that would be safe enough to apply in clinical settings as recommended
by the FDA.
* of the competition for patients in trials; and that it can be
important to consult informed patient on trial design; and to try to
harmonize research goals with the clinical needs of patients in
various clinical circumstances. To reach enrollment goals, a
study must compare favorably with all other standard and
investigational studies. Targeting the investigational drug to the
characteristics of the patients tumor is likely to make clinical
trials more attractive to patients and to their treating physicians (
the benefits of the National Biospecimen (NBN) approach to clinical
research to patients and to drug sponsors).
* of the need to modify intellectual property (IP) law so that patents
on molecular "defects" in cancer cells do not restrict
competition to develop drugs to target these defects.
Coincidentally, this concern was raised by a speaker at the
conference, and it caused quite a stir. Indeed, most researchers
I spoke to felt there is a need to modify the IP rules. One
suggestion is that we might reduce the patent life on
"defect" discoveries, and provide incentives for broad and
faster licensing - a way to maintain incentives to discover molecular
defects that drive cancer, without inhibiting competition for
development of drugs that target the defects. Probably this is
not a new idea among researchers, but I think the patient communities
and our representatives in government need to be made aware of this
significant obstacle to translational progress.
I came away with a deeper appreciation of the complexity of different
cancers, but also with a conviction that pre-clinical researchers are
on the right path. The task is to unravel the fundamental
molecular defects and pathways that cause malignant behavior in
different cancer types, and to selectively target these defects to
maximize effect and minimize toxicity. It is simply awesome to
contemplate how much has been achieved in terms of basic knowledge,
and how new tools are primed to accelerate our understanding
Indeed, we are in a revolution that will lead to the discovery and
selection of treatment based on the molecular targets (such as STAT3,
Myc, bcl-2, Src, angiogenesis factors, ... ), instead of by cancer
cell type (breast, lung, lymphoma...).
Is this not also a signal to advocacy groups -- representing patients
with different cancers -- to unify our efforts?
I can't help but believe that we already know enough about cancer
targets to dramatically improve the treatment of lymphomas, we need
only do the hard work of characterizing the variations of targets even
in the same diagnostic categories. For example, follicular
lymphomas all look like sedans on the outside, but they often have
very different engines under the hood.
Importantly, cancer survivors cannot be bystanders. The
metamorphism in cancer research, described by Dr. Von Eschenbach,
*requires* our participation in order to be fully realized, because
the discovery and translation of this knowledge, again, is dependent
on standardized capture, storage and analysis of tumor and normal
tissue. Comparable cells. Enabling identification of
patient-specific targets. We already know that
diagnostic-specific protocols are not good enough, and we know why.
I believe that cancer patients and caregivers can accelerate basic and
translational research by identifying centers that are enabling
research of the highest quality, and by contributing tissue to these
centers. This will make it possible to match existing and
investigational drugs to patient-specific molecular targets.
This approach could be a way to bypass even very good centers that
are, unfortunately, more interested in ownership than in sharing - or
moving these centers to change IP policy in ways that accelerate the
benefit to cancer patients, present and future.
Finally, I wish to express my thanks to AACR for the invitation to
exhibit at the conference.
Karl Schwartz BA, MFA
President, Patients Against Lymphoma
Caregiver and Patient Advocate
Patients Against Lymphoma
Education, Support, and Advocacy