Source: news.cincinnati.com
Author: Peggy O’Farrell

Two years ago this month, Pam Cain learned the bump on her tongue was really cancer. Last year, she learned the “bump” had spread to both lungs. “Last November, I was given two years if I only did chemo,” she said.

So she underwent radiation therapy. But the lesions on her lungs stayed put, and the cancer spread to one hip. So far, three chemotherapy combinations failed to kill her cancer.

Now Cain, 32, of Union is hoping an experimental targeted therapy will knock out her cancer. She was the second patient in the United States to receive the experimental drug, and one of about five patients now enrolled in four clinical trials for new cancer therapies at the University of Cincinnati.

The phase 1 trials are part of UC’s effort to raise its profile for cancer treatment and research. Phase 1 trials are the earliest stage of testing new medications or medical devices on humans. They’re designed to determine if a new treatment is safe, not whether it works.

For patients like Cain, who have run out of tried-and-true options, it means being able to get cutting-edge treatments close to home. “This way, I didn’t have to leave my kids,” she said. “I didn’t have to travel. I didn’t have to go someplace where I didn’t know anybody. And financially, it would have hurt.”

For the researchers and physicians who conduct the trials, it’s an opportunity to help find the next wonder drug. Olivier Rixe, who oversees UC’s phase 1 trials program, ran several clinical trials while on staff at the National Cancer Institute, including the initial trials for oxaliplatin, which is now prescribed to treat advanced colorectal and ovarian cancers.

“When you see these patients who’ve failed one, three, 10 drug regimens and then you finally get something that gets the results, that shrinks the tumor, that’s amazing,” Rixe said.

Cain has had one treatment with the experimental drug; she’ll get another this week. So far, she feels fine, she said, but the previous treatments she’s undergone have had some bad consequences. Radiation damaged her ability to make saliva, and one of the chemo drugs she took caused hearing loss.

Genes control the formation, growth and death of cells in the body. Cancer happens when those genes are damaged, which either triggers a process that allows abnormal cells to form and grow or blocks the process that would naturally kill them off. Chemotherapy and radiation kill cancer cells by bathing them with high levels of toxins, but they also kill healthy cells.

The four experimental drugs being tested at UC, including the one Cain is taking, are targeted therapies. If, for example, a cancer cell is formed when a damaged gene issues a specific protein, a targeted therapy would block that protein. Other targeted therapies work by killing off the blood vessels that feed tumor cells, while still others trigger the process of cell death, or apoptosis.

Targeted therapies cause fewer side effects because they don’t attack healthy cells, and it’s harder for cancer cells to outsmart them because they counteract basic cell functions, Rixe said.

“We need to have very smart concepts in new treatments,” he said. “Cancer cells are so smart. They can develop drug resistance and they can mutate and evolve around drugs.”

Before doctors can prescribe targeted therapies, they have to identify the targets – the genes, and the proteins they produce, that trigger cancer. That basic research is done on tumor samples and then in lab animals long before a drug ever gets to the phase 1 trial stage. Many new therapies never make it to the phase 2 stage; they’re unsafe, or don’t work any better than what’s already on the market.

UC officials hope they’ll soon be able to begin testing experimental therapies developed on their own campus. In the last year or so, the university has added about 30 new faculty – physicians and basic researchers – to its cancer program.

Cain hopes the medication they’re testing on her will work. After she takes her second treatment this week, doctors will take a scan to see if her tumors have shrunk.
“We’ll see how it goes. They’ll take the scan, and we’ll figure it out from there,” she said. “If this doesn’t work, we’ll figure something else out.”