UC cancer collaboration seeks combined clout
UC San Diego Moores Cancer Center is among five University of California sites participating in a new collaborative effort that aims to increase access to clinical trials, share research data and hone preventive efforts across the state.

UC San Diego Moores Cancer Center is among five University of California sites participating in a new collaborative effort that aims to increase access to clinical trials, share research data and hone preventive efforts across the state.

The proposal would formalize and deepen connections between the UC’s National Cancer Institute designated centers, said Dr. Scott Lippman, Moores director,

Taken together, the UC centers care for more than 16 percent of Californians diagnosed with a disease projected to kill nearly 60,000 Californians this year, according to the American Cancer Society.

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While that number is daunting, there is more hope these days than there has been perhaps at any time since President Richard Nixon declared war on cancer in 1971. In recent years, breakthroughs in immunotherapies — drugs that activate or piggyback on components of the body’s immune system — have brought significant increases in survivability and seen to generate new headline-worthy advances every single week.

Lippman said the pace of innovation in cancer therapy is so fast, that the best care available is often obtained by joining a trial run by a drug company headed for market. Becoming the home of one of these trials is not easy even if your operation is among the 69 government-designated centers in the nation, he said.

“There is tremendous competition for getting these trials. They’re investigational, in a certain sense, but they’re also the best cancer therapy that a person can get,” Lippman said.

While the collaboration announced in San Francisco Monday morning is about much more than clinical trial access, Lippman said that the added clout that can be gained by joining together will likely have the most immediately-visible impact for diagnosed patients.

In fact, he noted, it already has. The five centers have already built collaborative efforts around head and neck cancers and blood cancers that have brought trials systemwide that might not have appeared if only one cancer center was involved, he siad.

Dr. Ezra Cohen, a Moores head and neck specialist, was due to present an abstract of results of a promising trial at the European Society for Medical Oncology on Monday. That trial uses the immunotherapy drug Durvalumab, made by global medicine giant AstraZeneca, in conjunction with another drug called a STAT3 inhibitor.

Though the trial is still ongoing, early results are exciting, Cohen said in an email from Barcelona.

“We would expect to see a response rate of 10 percent to 15 percent with Durvalumab alone with few complete responses. We are seeing a doubling to tripling of the response rate with the addition of a STAT3 inhibitor,” Cohen said.

Getting that trial, Cohen and Lippman said, had a lot to do with the existing cross-collaboration between head and neck oncologists at various UC cancer centers. All had agreed to abide by the recommendations of Moores scientific review committee and institutional review board which must approve all clinical trials before they can proceed.

The ability to go through just one approval and have access to as many as five major cancer centers, Lippman said, definitely helped secure a trial in a competitive environment.

“We think this is obviously a major advantage,” Lippman said.

Dr. Alan Ashworth, president of the UCSF Helen Diller Family Comprehensive Cancer Center, agreed that the AstraZeneca trial is a good example of “one-off” collaborations that have occurred between different UC cancer centers in the past. The executive, who will direct the collaborative in its first year, said formalizing the relationship will hopefully make such joint effort the rule rather than the exception.

“What we want to happen down the road is that, when one center is considering applying for a trial it’s the standard practice to say ‘Hey guys, we’re setting this trial up, which of you guys is in?’” Ashworth said.

But he added that the collaboration is about much more than connecting more efficiently for trials.

Cancer research is increasingly moving away from categorizing cancers based on where they occur in the body. The new defining characteristic at the center of research is the disease’s specific genetic signature.

But spotting genetic mutations is the relatively easy part. Once those differences are delineated, researchers must use sophisticated data analysis tools to determine which are driving the disease and present an actionable target that can be exploited by a drug.

This analysis is aided by what computer scientists call “big data”: By looking across the clinical and genetic information of thousands of patients, cleverly designed computer algorithms can pick up on patterns that would not be apparent by looking at one patient at a time.

Here, Ashworth said, collaborating more closely, and sharing data sets, can help researchers make the next wave of discoveries more quickly.

“We’re not big enough on our own, sometimes, for this kind of work, but together we’re going to see the big picture of cancer in ways we never have before,” Ashworth said.

He said that there is also room for collaboration on cancer prevention programs whether it’s finding the best way to get people to stop smoking or to get those over age 50 to undergo the routine colonoscopies that are proven to reduce the chances of colon cancer.

Looking across institutions at what is effective in one place versus another, he said, should enable new insights about what truly motivates and what just gets ignored.

“We can now start to use the data from our electronic medical records to look at similarities and difference in outcomes and treatment and also around cost,” Ashworth said.

In addition to Moores, the organizations that make up the consortium are: UC Davis Comprehensive Cancer Center, the UC Irvine Chao Family Comprehensive Cancer Center, the UCLA Jonsson Comprehensive Cancer Center and the UCSF Helen Diller Family Comprehensive Cancer Center.

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paul.sisson@sduniontribune.com

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