Clinical trials changing the face of cancer

While knowledge of cancer and initial treatments have been around for hundreds of years, it is only within the last two centuries that significant advances in cancer treatment have taken place. From surgery and radiation therapy through to the latest in immunotherapy all these advances have started with the most important building block – research and clinical trials. With the launch of our broadened clinical trials program at Icon Cancer Centre in Singapore, which is part of Icon’s international research function, I wanted to share a little about the role of clinical trials and their incredible contribution to the future of cancer care.

Clinical trials seek to answer and solve scientific questions in the hopes that we can discover new and improved ways to treat, prevent and even eliminate cancer. New drug treatments are typically tested and developed throughout four clinical trial phases. At the early phases, the new drug or regime is tested in a small number of participants and safely assesses effectiveness. Moving through the phases, the number of people participating increases, and more data is collected, such as any side effects or comparisons with standard treatments, all to form evidence-based findings that may eventually lead to new treatments being available for patients with cancer.  

Outside of drug-based clinical trials there are also unique research studies that focus on supporting the development of new treatment practices and guidelines and comparing the effectiveness of existing treatments. In 1995 a new radiation therapy technique, known as stereotactic radiation therapy, was invented. By using precise technology which targets radiation directly to the cancer, stereotactic radiation therapy can be delivered in one to five treatments compared to traditional radiation therapy which delivers smaller doses over many weeks. This milestone evolution could not have been possible without extensive research studies and multidisciplinary clinical teams undertaking a wide-range of controlled tests, comparisons and data analysis.

So what’s next in cancer research? Immunotherapy is an emerging type of treatment that uses the body’s own immune system to fight cancer cells. In 1992, the clinical antibody Herceptin was developed; a trial Icon was heavily involved in. Herceptin is regarded as a revolutionary immunotherapy treatment for breast cancer and today is effectively used to treat HER2 positive breast cancer. There are many different kinds of immunotherapy like Herceptin which all work to slow the growth and spread of cancer cells. Some examples include checkpoint inhibitors – medicines that help the immune system respond more strongly to a tumour, and CAR-T cell therapy, where a patient’s T cells (a type of immune system cell) are altered to allow them to effectively target and attack cancer cells within the body. Immunotherapy continues to represent an innovative and promising approach to cancer treatment with many Phase I trials currently focussing on the advancement of this therapy.

We are also seeing incredible advances being made in the field of radiation therapy as technology continues to evolve, with research studies playing a significant role in driving this forward. For example, Artificial Intelligence (AI) is increasingly being used to improve the precision of radiation machines. This allows clinicians to adjust how treatment is delivered in real time by monitoring the patient’s internal and external anatomy, accounting for the natural shift of organs or slight changes in the size and shape of the tumour which results in highly precise radiation delivery.

It is important to understand that clinical trials play an integral role in the delivery of the best possible patient care. For many patients, it can provide a new line of treatment when they have exhausted all other opportunities and for others it can help to extend their lives, revisit treatments previously not available to them, and provide a better quality of life. Participation from patients and investment from sponsors, researchers and clinicians is necessary to push research forward. Greater education in understanding the safety and strict governance behind every trial should be shared across communities to demystify trials and enhance uptake. We have seen the effect that COVID-19 has had on accelerating the delivery of clinical trials and investment in emerging treatments, and are committed to using this increased momentum and our learnings from this time to provide greater access to cancer research.

As a healthcare professional, I believe strongly in the promotion of clinical trials and research. It is what allows us to fight diseases like cancer and provide hope and opportunity to patients today and into the future. At Icon we are fortunate to have a group of oncologists and researchers passionate about providing increased access to clinical trials and are proud to invest in a robust clinical trials program to help more people. There is no doubt clinical trials should and must be part of the cancer care journey to allow us to discover breakthroughs in treatment and ultimately change the face of cancer.