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Cancer Trials Struggle For Patients, Funds

Small Percentage Of Patients Try New Treatments

Thursday, September 4, 2008

The medical community in places such as Boston is busy working on hundreds of clinical trials -- each one holding the promise of changing the future of cancer treatment. But researchers told Boston television station WCVB they face challenges in both finding willing patients and federal funding.

Video: Trials Need Patients

Kristin Hoke, 40, is not only willing to participate in a clinical trial, she flew from West Palm Beach, Fla., to do so. She's left her husband and toddler behind in the hopes an experimental treatment will save her life.

"Best case scenario would be that this once-and-for-all takes care of my cancer," she said. "Seems like my body just keeps wanting to make cancer over and over again."

It's already been a long journey for the young mother. Hoke was married only one year when she was first diagnosed with breast cancer. It's a disease that had already struck her mother, aunt and sister. Only her sister is still alive.

"Bella, my daughter, was 3 months to the day when I was re-diagnosed with my recurrence," Hoke said. "I had a cough during my maternity leave that wouldn't go away. And I couldn't figure out what was wrong. (The doctors) weren't sure, so they did a test to see if I had pneumonia, and that's when they found the cancer all through my torso. And it was devastating."

Hoke, a television news anchor at WPBF-TV, has tried nearly every treatment available to beat down this disease.

Her oncologist recommended her for a spot in a clinical trial at Dana-Farber Cancer Institute. Researchers are studying whether a treatment, called a PARP inhibitor, might be effective for patients with the breast cancer gene.

"We do know that in women with ovarian cancer, who have a similar gene mutation, that the treatment's been effective," said Dr. Eric Winer, director of the breast oncology center. "So, no guarantees. That's unfortunately often the case with early-phase clinical trials. But it's very promising."

So are many of the other 350 clinical trials going on right now in Boston -- each one representing hope for a new cancer treatment.

"Cancer isn't one disease. It's literally hundreds of different kinds of diseases," said Dr. George Demetri, director of the Center for Sarcoma and Bone Oncology. "So our clinical trials are getting more specific for individual kinds of patients. Patients with certain kinds of proteins driving their cancer where we can develop smart drugs to go after just what's wrong with the cancer cell and leave the normal cell alone."

Hoke is eager to participate, but only 5 to 8 percent of cancer patients will ever be in a clinical trial. Researchers said that can be to the detriment of science and patients.

"Doctors sometimes don't even tell patients what clinical trials are available," said Demetri. "And in our day and age, increasingly, patients and their families have to be their own advocates."

Demetri said it used to take 10 years to get Food and Drug Administration approval for new treatments. Now, four years is typical. He said federal funding has shrunk while the role of drug companies has expanded.

"We're all a little bit worried in academia that an increasing proportion of what actually gets tested in people is driven by the agendas of large, for-profit biotechnology or pharmaceutical companies," Demetri said. "Now, I collaborate with these pharmaceutical companies, and I know there are a lot of good and ethical people there, but I also recognize that from a national perspective, we might want to take back that control for what's best for the patients."

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