THE RATE OF CANCER SURVIVORSHIP in our nation continues to rise steadily, with more and more cancer patients now living longer lives—or even completely cancer-free—than ever before. Among the many factors influencing this encouraging trend are exciting advancements in the realm of personalized cancer therapy.
According to Tim Kasunic, MD, of The Toledo Clinic Cancer Centers, personalized cancer therapy involves the molecular profiling of cancers to determine the best approach to treatment, and is an area that has driven significant improvement in cancer care in recent years. “For example, immunotherapy— or treatment that helps the immune system recognize and attack cancer cells—is now used more often than not in treating cancer. In fact, some forms of lung cancer are initially treated with immunotherapy only. There are only a few cancer types for which immunotherapy has not yet been proved effective, but ongoing clinical studies are exploring ways to use it for these cancers as well,” he says.
Dr. Kasunic notes that one way doctors can help determine how effective immunotherapy will be in treating a patient’s cancer is to check for certain proteins called PD-L1 and PD-1. PD-L1, which is present on the surface of some cancer cells, binds to PD-1, which is found on the T cells of the immune system, enabling the cancer to evade the body’s natural immune response. Targeted therapies can be used to block these proteins, thereby exposing “camouflaged” cancer cells so the immune system can recognize and attack them.
“We can also evaluate other aspects of the cancer to determine whether immunotherapy is appropriate. For example, in one patient with pancreatic cancer—which is a tough cancer to treat—we found a certain biological characteristic that suggested it might respond well to immunotherapy, and it did, indeed, respond. By looking for mutations in cancer or proteins that drive cancer, we’re finding more and more ways to use targeted treatments, many of which are in pill form. For lung cancer alone, we now have nine mutations we can test for to determine whether a patient is a candidate for targeted treatment,” Dr. Kasunic says.
In some cases, finding a characteristic commonly associated with one form of cancer can lead to a breakthrough in treating a patient with an entirely different cancer type. Dr. Kasunic gives the example of a patient with metastatic cervical cancer whose cancer tested positive for HER2—a protein more commonly linked with breast cancer. “After several years on antibodies targeting HER2, and with no chemotherapy, this patient has experienced minimal side effects and is currently cancer-free. So, we’re able to offer treatment based on the biology of a cancer, not the site,” he says.
Cancer patients will also appreciate the fact that targetable cancer mutations can now be detected using blood tests that are nearly as effective as the traditional technique, which involves analyzing a sample of tumor tissue.
Dr. Kasunic states that one of the approximately 50 clinical trials currently open at The Toledo Clinic Cancer Centers is a study in which patients can have antibodies added to their treatment regimen. The study’s purpose is to find ways to overcome immunotherapy resistance, and the results so far have been very encouraging. Dr. Kasunic comments, “If we don’t offer a particular study that might benefit one of our patients, we can check with our partners at Karmanos Cancer Institute or other regional cancer centers to find a suitable trial.”
With the recent opening of the Karmanos Cancer Institute at The Toledo Clinic Cancer Centers in Maumee, residents from Toledo and the surrounding communities now have access to the most comprehensive cancer care available anywhere in Northwest Ohio—including many services formerly available only out of town. “We also have a transplant physician available for consultation at the new Maumee center, and we’re working with our Karmanos partners on expanding our clinical trials. In addition, we’re working closely with the University of Toledo, collaborating with their oncology services as well as their clinical studies,” Dr. Kasunic remarks.
The Toledo Clinic Cancer Centers, located at 4126 N. Holland Sylvania Road, Suite 105, also provides imaging, laboratory, chemotherapy, specialized pharmacy, and IV services. The cancer center consists of 10 medical and 3 radiation oncologists along with 9 advanced practice providers. The cancer center also has satellite centers in Maumee, Napoleon, Bowling Green, Wauseon, and Monroe.
The Toledo Clinic Cancer Centers has earned Patient-Centered Specialty Practice recognition and Oncology Medical Home recognition from the National Committee for Quality Assurance. Oncology homes align systems and resources with coordinated care focused on cancer patients and their needs. This reduces fragmentation, supports shared decision making, and improves the patient experience. They are the first oncology practice in the state of Michigan and the second oncology practice in the state of Ohio to receive this recognition. For more information, please call The Toledo Clinic Cancer Centers at 419-479-5605.
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