For some time now, we have been interested in finding ways to move the field toward what are called “rapidly adaptive” clinical trials. This past September, the brain tumor research community took a big step forward in driving a shift in how trials are designed and implemented.
On September 19-20, the National Cancer Institute(NCI) and Accelerate Brain Cancer Cure(ABC2) co-hosted a groundbreaking clinical trials conference. This was the first time NCI partnered with a venture philanthropy group to co-host this type of meeting. In addition to the trials planning, ABC2 invited top researchers working on related topics such as genomic profiling, informed consent, IRB approvals, imaging and biomarkers. For a detailed conference agenda and topic descriptions, please click here.
Currently, a patient finds their way to a trial, enrolls, and is then basically stuck in that trial for the duration. With the genomic tumor profiling and biomarker tools that are under development, it is now becoming possible in some cancers to match specific tumor types to specific targeted treatments. With rapidly adaptive trials, the idea is to try a specific matched agent, use the new tools to monitor its effectiveness, and if it does not show effect, quickly try the next agent, and so on and so on. This has now been done breast cancer, where there is fairly straightforward access to tumor tissue and where there are several different treatment options available.
We are just now coming to the point where this approach can be looked at for brain cancer. New imaging technologies and biomarkers, combined with the emergence of several new targeted agents, make this seem like a real possibility. The time now seems ripe to drive a shift in how trials are designed and implemented and this combined ABC2/NCI meeting is a major catalyst for that shift.
Max Wallace, CEO of Accelerate Brain Cancer Cure