TheoryLab

Clinical trials are the key step in advancing potential new cancer treatments out of the lab and into the clinic. Patient participation in trials is crucial to this success.

But only a small fraction of patients end up enrolling in a cancer clinical trial due to barriers that make participation difficult or even impossible. As a result, approximately 20% of cancer clinical trials fail due to insufficient patient enrollment. Understanding and addressing these barriers is critical to accelerating progress in cancer research.

Mark Fleury, PhD, is Policy Principal at ACS CAN – the American Cancer Society Cancer Action Network (https://www.fightcancer.org/). Dr. Fleury joined the podcast to help us understand where we are falling short and how we can reduce these barriers to patient enrollment in clinical trials.

5:36 – What is ACS CAN?

7:55 – A recent piece of cancer-related legislation where ACS CAN was involved that he is particularly proud of

13:07 – Why clinical trials in cancer research are so important to patients

16:23 – On barriers to clinical trial enrollment: ACS CAN resources note that “approximately 20% of cancer clinical trials fail due to insufficient patient enrollment.” Why are we falling short?

22:50 – Some of the recommendations ACS CAN has helped identify that would reduce barriers to enrollment in cancer clinical trials

27:04 – How clinical trial matching services could be improved

32:38 – On disparities in clinical trial participation

Resistance to treatment – it’s one of the most important issues in cancer research. If cancer cells aren’t killed during treatment, either because they weren’t affected or because they changed enough to survive the treatment, it could lead to cancer recurrence.

Tuomas Tammela, MD, PhD, has an American Cancer Society grant to explore resistance to treatment in lung adenocarcinoma, the most common subtype of lung cancer.

In this conversation he walks us through new findings from his lab on the “highly plastic state” of certain cells in tumors. He explains how this relates to tumor heterogeneity, why this is a problem in lung cancer and other cancer types, and how it could be used in combination therapies.

Tuomas Tammela, MD, PhD, is Assistant Member at the Sloan Kettering Institute at Memorial Sloan-Kettering Cancer Center.

3:01 – What does it mean for cancer to become resistant to treatment?

5:24 – What does resistance to treatment mean in terms of the cellular makeup of a tumor?

7:21 – A helpful way to understand “tumor heterogeneity”

9:31 – What it means for cells to be in a “highly plastic state” and why that’s importance to treatment resistance and cancer progression

13:05 – Is the “highly plastic cell state” seen in different cancer types and…

14:46 – …could it be targeted therapeutically?

16:51 – How tumor heterogeneity impacts treatment resistance in lung cancer

20:42 - If later stage lung cancer tumors are more heterogenous, what could help us understand how to treat them?

25:12 – On how American Cancer Society funding has impacted his research

26:41 – A message he’d like to share with cancer patients and caregivers

Resistance to treatment – it’s one of the most important issues in cancer research. If cancer cells aren’t killed during treatment, either because they weren’t affected or because they changed enough to survive the treatment, it could lead to cancer recurrence.

Tuomas Tammela, MD, PhD, has an American Cancer Society grant to explore resistance to treatment in lung adenocarcinoma, the most common subtype of lung cancer.

In this conversation he walks us through new findings from his lab on the “highly plastic state” of certain cells in tumors. He explains how this relates to tumor heterogeneity, why this is a problem in lung cancer and other cancer types, and how it could be used in combination therapies.

Tuomas Tammela, MD, PhD, is Assistant Member at the Sloan Kettering Institute at Memorial Sloan-Kettering Cancer Center.

3:01 – What does it mean for cancer to become resistant to treatment?

5:24 – What does resistance to treatment mean in terms of the cellular makeup of a tumor?

7:21 – A helpful way to understand “tumor heterogeneity”

9:31 – What it means for cells to be in a “highly plastic state” and why that’s importance to treatment resistance and cancer progression

13:05 – Is the “highly plastic cell state” seen in different cancer types and…

14:46 – …could it be targeted therapeutically?

16:51 – How tumor heterogeneity impacts treatment resistance in lung cancer

20:42 - If later stage lung cancer tumors are more heterogenous, what could help us understand how to treat them?

25:12 – On how American Cancer Society funding has impacted his research

26:41 – A message he’d like to share with cancer patients and caregivers

It is no exaggeration to say that Jennifer Temel, MD, has helped change how cancer care is practiced.

Through her research, she has shown that integrating palliative care and oncology care from the time of cancer diagnosis improves patient outcomes. This early integrated care model is now the standard of care in the United States and many other countries.

Now, however, because it’s the standard of care, demand for early palliative care is so great that the palliative care workforce is unable to meet every patient’s needs.

So Dr. Temel is now working to use novel healthcare technologies—such as telehealth and mobile apps—to deliver patient-centered palliative care to cancer patients and their families everywhere.

Jennifer Temel, MD, is an American Cancer Society Clinical Research Professor. She is Professor of Medicine at Harvard Medical School and Director of the Cancer Outcomes Research Program at the Massachusetts General Hospital Cancer Center.

2:17 – On what motivated her to become an oncologist

3:20 – What is palliative care? How can palliative care differ from the care provided by an oncology clinician?

4:48 – On the importance of early palliative care for patients with serious cancers

7:06 – On her seminal research findings showing that integrating palliative care with oncology care leads to better outcomes

8:32 – How cancer caregivers are impacted by palliative care

10:21 – On how palliative care is typically offered, drawbacks to the current delivery system, and communicating well with patients and their families

16:30 – On being named an ACS Clinical Research Professor

17:40 – On the goals of her ACS-funded work: using healthcare technology to better support and inform cancer patients…

21:25 – …and the three technologies she’s focused on

28:35 – How the pandemic has impacted the need to be innovative in how palliative care is provided

32:49 – How ACS and the cancer community at large can help scale her findings

35:46 – A message she’d like to share with cancer patients and caregivers

It is no exaggeration to say that Jennifer Temel, MD, has helped change how cancer care is practiced.

Through her research, she has shown that integrating palliative care and oncology care from the time of cancer diagnosis improves patient outcomes. This early integrated care model is now the standard of care in the United States and many other countries.

Now, however, because it’s the standard of care, demand for early palliative care is so great that the palliative care workforce is unable to meet every patient’s needs.

So Dr. Temel is now working to use novel healthcare technologies—such as telehealth and mobile apps—to deliver patient-centered palliative care to cancer patients and their families everywhere.

Jennifer Temel, MD, is an American Cancer Society Clinical Research Professor. She is Professor of Medicine at Harvard Medical School and Director of the Cancer Outcomes Research Program at the Massachusetts General Hospital Cancer Center.

2:17 – On what motivated her to become an oncologist

3:20 – What is palliative care? How can palliative care differ from the care provided by an oncology clinician?

4:48 – On the importance of early palliative care for patients with serious cancers

7:06 – On her seminal research findings showing that integrating palliative care with oncology care leads to better outcomes

8:32 – How cancer caregivers are impacted by palliative care

10:21 – On how palliative care is typically offered, drawbacks to the current delivery system, and communicating well with patients and their families

16:30 – On being named an ACS Clinical Research Professor

17:40 – On the goals of her ACS-funded work: using healthcare technology to better support and inform cancer patients…

21:25 – …and the three technologies she’s focused on

28:35 – How the pandemic has impacted the need to be innovative in how palliative care is provided

32:49 – How ACS and the cancer community at large can help scale her findings

35:46 – A message she’d like to share with cancer patients and caregivers

Just as telemedicine is changing the ways in which primary care is delivered, much of cancer care can be delivered safely, effectively and less expensively from home.

Penn Home Infusion Therapy has been providing infusion therapy at home for around two decades, but starting last year, in November 2019, just a few months before the pandemic started to complicate health care in America, Penn Medicine launched Cancer Care at Home.

A joint initiative of the Penn Center for Cancer Care Innovation, the Center for Healthcare Innovation and the Division of Hematology and Oncology at Penn, the goal of the program is “to establish the home as a place where appropriate patients can receive appropriate care.”

In this conversation, Dr. Justin Bekelman and Katherine Major describe the benefits of Cancer Care at Home, some of the barriers for home care that exist in America, and how the program navigated a 700% increase in patient care when the Covid-19 pandemic took hold in America.

Justin Bekelman, MD, a former American Cancer Society grantee, is Professor of Radiation Oncology and Medical Ethics and Health Policy as well as the Director of the Penn Center for Cancer Care Innovation.

Katherine Major, MSN, RN, CHPN, is a registered nurse and a director of Penn Medicine at Home. She oversees the Penn Home Palliative Care and Penn Home Infusion Therapy programs.

6:09 – The benefits of delivering cancer care at home

9:17 – On how cancer care is delivered at home – What treatments can be administered safely and effectively at home? What symptoms can be managed in home environments?

14:43 – On sorting out who can be treated at home and who needs to be treated in a clinical setting

18:54 – On the staffing resources needed to safely provide cancer care at home

22:35 – On some of the roadblocks patients, caregivers and care teams need to navigate

27:14 – How the Cancer Care at Home program navigated the difficult period when the pandemic startd to take hold in America

31:42 – Some wonderful patient stories

36:47 – How ACS funding helped Dr. Bekelman “take science from inception to scale”

39:18 – A message they’d like to share with cancer patients, caregivers, and survivors

Just as telemedicine is changing the ways in which primary care is delivered, much of cancer care can be delivered safely, effectively and less expensively from home.

Penn Home Infusion Therapy has been providing infusion therapy at home for around two decades, but starting last year, in November 2019, just a few months before the pandemic started to complicate health care in America, Penn Medicine launched Cancer Care at Home.

A joint initiative of the Penn Center for Cancer Care Innovation, the Center for Healthcare Innovation and the Division of Hematology and Oncology at Penn, the goal of the program is “to establish the home as a place where appropriate patients can receive appropriate care.”

In this conversation, Dr. Justin Bekelman and Katherine Major describe the benefits of Cancer Care at Home, some of the barriers for home care that exist in America, and how the program navigated a 700% increase in patient care when the Covid-19 pandemic took hold in America.

Justin Bekelman, MD, a former American Cancer Society grantee, is Professor of Radiation Oncology and Medical Ethics and Health Policy as well as the Director of the Penn Center for Cancer Care Innovation.

Katherine Major, MSN, RN, CHPN, is a registered nurse and a director of Penn Medicine at Home. She oversees the Penn Home Palliative Care and Penn Home Infusion Therapy programs.

6:09 – The benefits of delivering cancer care at home

9:17 – On how cancer care is delivered at home – What treatments can be administered safely and effectively at home? What symptoms can be managed in home environments?

14:43 – On sorting out who can be treated at home and who needs to be treated in a clinical setting

18:54 – On the staffing resources needed to safely provide cancer care at home

22:35 – On some of the roadblocks patients, caregivers and care teams need to navigate

27:14 – How the Cancer Care at Home program navigated the difficult period when the pandemic startd to take hold in America

31:42 – Some wonderful patient stories

36:47 – How ACS funding helped Dr. Bekelman “take science from inception to scale”

39:18 – A message they’d like to share with cancer patients, caregivers, and survivors

Dawn Hershman, MD, MS, was recently named an American Cancer Society Clinical Research Professor for the seminal contributions she’s made to the field of cancer health services research.

Her contributions to the field are so wide ranging and impactful, they defy summary.

From identifying patients who are at risk of receiving poor cancer care and intervening to improve their outcomes, to conducting trials to improve patients’ compliance with care, to examining strategies to manage cancer-related toxicities, Dr. Hershman’s work has had a remarkable impact on cancer patients’ quality of care and quality of life.

She has also been a leader in health equity and cancer disparities, demonstrating why Black cancer patients may have worse outcomes and improving clinical trial recruitment and retention of Black patients.

Dawn Hershman, MD, MS, is Professor of Medicine and Epidemiology at Columbia University Medical Center.

3:49 – What kinds of things can stand in the way of patients receiving optimal cancer therapy?

8:01 – On breast cancer patients who are more at risk than others for poor treatment and outcomes

11:55 – On what the cancer treatment community should be doing NOW to improve quality of care for breast cancer patients and narrow disparities

15:12 – On the many different ways we could improve quality of life for breast cancer patients

18:36 – Why QOL issues can be challenging for patients and physicians

23:07 – On the significant impact that the expense of cancer treatment can have on breast cancer patients, and possible cost reduction strategies

26:02 – On what she hopes to accomplish with her new American Cancer Society ACS funding…

28:09 – …and how she hopes her research could help patients

29:44 – How organizations such as the American Cancer Society could help disseminate her findings

32:19 – A message she’d like to share with cancer patients, survivors and caregivers

Dawn Hershman, MD, MS, was recently named an American Cancer Society Clinical Research Professor for the seminal contributions she’s made to the field of cancer health services research.

Her contributions to the field are so wide ranging and impactful, they defy summary.

From identifying patients who are at risk of receiving poor cancer care and intervening to improve their outcomes, to conducting trials to improve patients’ compliance with care, to examining strategies to manage cancer-related toxicities, Dr. Hershman’s work has had a remarkable impact on cancer patients’ quality of care and quality of life.

She has also been a leader in health equity and cancer disparities, demonstrating why Black cancer patients may have worse outcomes and improving clinical trial recruitment and retention of Black patients.

Dawn Hershman, MD, MS, is Professor of Medicine and Epidemiology at Columbia University Medical Center.

3:49 – What kinds of things can stand in the way of patients receiving optimal cancer therapy?

8:01 – On breast cancer patients who are more at risk than others for poor treatment and outcomes

11:55 – On what the cancer treatment community should be doing NOW to improve quality of care for breast cancer patients and narrow disparities

15:12 – On the many different ways we could improve quality of life for breast cancer patients

18:36 – Why QOL issues can be challenging for patients and physicians

23:07 – On the significant impact that the expense of cancer treatment can have on breast cancer patients, and possible cost reduction strategies

26:02 – On what she hopes to accomplish with her new American Cancer Society ACS funding…

28:09 – …and how she hopes her research could help patients

29:44 – How organizations such as the American Cancer Society could help disseminate her findings

32:19 – A message she’d like to share with cancer patients, survivors and caregivers

In the TheoryLab podcast, we usually highlight the work of American Cancer Society scientists and funded researchers. But in this episode, we speak with some amazing women who exemplify why we support cancer research.

In this two-part episode, you'll hear from a metastatic breast cancer THRIVER, a cancer survivor, and the managing director of Making Strides Against Breast Cancer (MSABC).

(2:49) First, we spoke with Valerie Mortimer—a metastatic breast cancer thriver—and Joya Harris—a stage 3 breast cancer survivor. They shared what it was like to be diagnosed with breast cancer, how they found strength during their journey, and advice they have for newly diagnosed patients. They also talked about how helpful it can be to become part of a community of survivors and caregivers.

(26:40) In the second half of the episode, we spoke with Susan Petre, Managing Director of Making Strides Against Breast Cancer. What is Making Strides? How much money is raised through it, and how does the American Cancer Society use those funds? She also talks about how the event has changed this year in response to the pandemic. And she ends by talking about some of her favorite memories from Making Strides events over the years.