The Big Picture for 2017: 6 Experts Weigh In

Anita T. Shaffer @Shaffer1
Published: Sunday, Jan 01, 2017
Howard A. “Skip” Burris, MD

Howard A. “Skip” Burris, MD

Two of the most noteworthy developments in the oncology field during 2016 were the continued expansion of checkpoint blockade immunotherapy agents into more cancer types and the federal government’s plans for funding and remaking the research paradigm.

In the clinical arena, antibodies that target the PD-1/PD-L1 pathway maintained the rapid pace of approvals that has marked their trajectory since the first agent in this category was approved 2 years ago.

The PD-1 inhibitors nivolumab (Opdivo) and pembrolizumab (Keytruda) gained the FDA’s approval in head and neck cancer; nivolumab also was approved in Hodgkin lymphoma while pembrolizumab landed an expanded indication in non–small cell lung cancer (NSCLC). Meanwhile, atezolizumab (Tecentriq) became the first PD-L1 antibody to clear regulatory hurdles and is now approved in bladder cancer and NSCLC.

In the political arena, a campaign that has helped focus national attention on cancer research culminated with President Obama signing the 21st Century Cures Act in mid-December. The legislation endorses spending $6.3 billion over 7 years for opioid addiction, precision medicine, the BRAIN initiative, and mental illness, including $1.8 billion for cancer research and care.

Key provisions expected to advance cancer research include a requirement that data from studies funded by the National Institutes of Health (NIH) be shared among scientists, a condition that is intended to speed up the pace of discovery.1

Looking forward to 2017, how can we expect these developments to unfold? To find out what might be on the horizon, OncLive spoke with prominent leaders in the field in recent weeks. Here, we present their thoughts.

Howard A. "Skip" Burris III, MD

Sarah Cannon Research Institute

As chief medical officer at Sarah Cannon Research Institute, Howard A. "Skip" Burris III directs the initiation and progress of more than 200 early-phase oncology drug trials annually in communities throughout the United States.

Burris believes the federal Cancer Moonshot initiative, which has now been incorporated into the 21st Century Cures Act, has helped generate important conversations about oncology research and care within the field while focusing renewed public attention on cancer.

“It’s been a long time since President Nixon declared the war on cancer back in the early ‘70s and, with a number of new therapies, to regenerate that level of enthusiasm is so needed,” said Burris, a 2014 Giants of Cancer Care winner. Sarah Cannon is playing a key role in the Moonshot initiative in several ways. The institute is helping to lead a $12 million research project that is aimed at studying and standardizing the role of oncology nurse navigators in patient care.

“We’ve invested widely in nurse navigation, which is the idea that when a patient is first given the diagnosis of cancer, we have a nurse navigator help streamline and accelerate their access to the experts—not to step in front of the physicians but simply to coordinate so that patients get their questions answered, that they’re seeing the various subspecialists that might need to be involved in their case,” said Burris.

“The idea is that this will accelerate the accrual for patients into trials through education and awareness,” he added. “Patients would receive greater combined modality and multidisciplinary approaches to their cancer as part of that goal.”

To implement the program, Sarah Cannon has invested in a software platform that captures data on patients as they move through the system. Burris said data on more than 30,000 patients have been entered into the navigation program.

Similarly, the institute is developing systems to put genomic data on patients into usable formats and in natural language programs to incorporate reports into electronic records starting with radiology and pathology.

Burris feels the data-sharing culture that federal officials are seeking can be promoted thorough systems that give patients access to their own information. “Sarah Cannon is trying to advocate the idea that it’s the patient’s data, “ he said.

“Getting the various collaborators to coordinate and to participate in sharing will be a bit of a challenge,” said Burris. “I do think that with where we’re moving in the direction of having molecular profiling information, where we’re seeing clinical trials that are looking at matching patients, lends itself to the idea that we’re going to have to work together. We’re treating patients much more individually.”

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