Vero Beach’s Scully-Welsh Cancer Center is playing with the big kids now.
The Treasure Coast cancer center has joined a list of some of the nation’s most respected medical institutions – including Memorial Sloan Kettering, the Dana-Farber Cancer Institute, Maryland’s Johns Hopkins, the Moffitt Cancer Center and the Walter Reed National Medical Center – enrolling patients in a complex, nationwide clinical trial.
The “Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials” (or ALCHEMIST) trials are, according to the National Cancer Institute, “a group of randomized clinical trials for patients with early-stage non-small-cell lung cancer whose tumors have been completely removed by surgery.”
So why, if tumors have already been surgically removed, does such a massive clinical trial – involving hundreds of hospitals and cancer centers across the country – need to be undertaken?
Simple. Because, as of now, NCI says, “There is a 50 percent chance that the cancer will come back,” even after all existing tumors have been cut away.
Scully-Welsh medical oncologist Dr. Stephen Patterson echoes that NCI finding, saying, “We know that even after surgery, patients can have a risk that the cancer’s going to come back,” and then he adds, “so far, we have had some strides forward using chemotherapy to reduce the risk of recurrence, but there’s still a lot of room to go.”
Then Patterson’s expression changes and a broad smile comes to his face. He calls this ALCHEMIST project “an exciting trial for patients who have had fully resected lung cancer; this trial is using newer drugs that are targeted and have smaller toxicities. And in patients who have metastatic cancer, they’ve already proven to be much more effective than ordinary chemotherapy.”
This particular trial is all about genes. Or, at least, it’s mostly about genes.
As NCI puts it, “Recent advances in deciphering the cancer genome have enabled the development of targeted therapies that have fundamentally changed our approach to cancer treatments.”
NCI goes on to endorse what it calls this style of “precision medicine.”
Perhaps paradoxically, however, developing “precision” medicine often requires casting a very wide net. Memorial Sloan Kettering estimates that over 8,000 potential participants for the ALCHEMIST trials will be screened and that “each arm of the trial will [likely] enroll approximately 400 patients.”
The trial is a three-pronged look into certain cancer-causing gene mutations as well as new medications. Specifically, it involves the “epidermal growth factor receptor” (or EGFR) and the “anaplastic lymphoma kinase” (or ALK) receptors. For patients who do not have the EGFR or ALK gene changes, the ALCHEMIST trial will compare and evaluate the immunotherapy drug nivolumab or Opdivo with the current standard of care for non-small cell cancers.
Admittedly, there’s a lot of the alphabet and an overabundance of capital letters to digest in the paragraph above, but Scully-Welsh clinical research nurse coordinator Monica Richardson offers a simpler approach.
First, she says, talk to your doctor and discuss the ALCHEMIST screening trial. Information is available at the center. If your physician thinks you might be a fit, discuss having your tumor sample tested and providing a blood sample.
Patterson calls Opdivo “an exciting, exciting drug that’s finding application in lots and lots if cancers. It’s had a substantial benefit to the survival for patients with lung cancer in the metastatic setting. And now we’ll be able to see if the patients who don’t have these mutations – EGFR or ALK – if the Opdivo or nivolumab drug will minimize their recurrence rate as well.”
For more information contact the Scully-Welsh Cancer Center at 772-563-4673. Additional information can be found online at https://www.cancer.gov/types/lung/research/alchemist or at https://clinicaltrials.gov and use the “search for studies” box on the left side of the page by typing in ALCHEMIST.
