[00:00:00] Speaker A: Foreign.
[00:00:08] Speaker B: My name is Nancy Farrow, also known as Mama Lou, and I'm the founder of Epic Experience.
Epic Experience mission is to empower adult cancer survivors and thrivers to live beyond cancer.
I hope that as you listen to campfires of hope living beyond cancer, you find hope, healing and empowerment.
Through stories and education, we aim to guide those impacted by cancer and more importantly, offer love and support to anyone out there who needs it.
This is beyond cancer.
[00:01:13] Speaker C: Hello, this is Gail, AKA Sunshine. Welcome to episode one of a special two episode series where we're going to be discussing clinical trials with medical professionals and the professionals that we have. Joining us are Dr. Liu and Dr. Wilke of the University of Colorado Cancer Center. Thank you both so much for being with us here today.
We're going to start with episode one. Since this is the first time listeners are getting to know you, if you can just tell us a little bit about yourself. Quick background bio.
Dr. Liu, I'm going to let you go first.
[00:01:50] Speaker A: That sounds good. Hi everybody. I'm Chris Liu. I'm a GI medical oncologist, which means I'm a cancer doctor that specializes in gastrointestinal cancers. I also serve as the associate director for clinical research for the University of Colorado cancer center.
[00:02:07] Speaker D: I'm Dr. Breland Wilkie. I am a medical oncologist focusing in sarcomas, which are very rare cancers of bone and soft tissue.
I also serve as the deputy associate director for clinical research and part of that role is leading a committee at our cancer center that focuses on investigator initiated clinical trials.
[00:02:27] Speaker C: Wonderful. Thank you so much again, both of you for being here. So here on episode one, what we're going to do is stay a little high level in general about clinical trials. So let's dive right in. So how do clinical trials contribute to advancing cancer treatment and what breakthroughs have come through past trials? And I'm going to let either of you kind of jump in.
[00:02:52] Speaker A: I'm happy to start.
We are absolutely in the most exciting time ever in the history of treating and preventing cancer. We have seen advances over the last several decades that I think we would never have dreamed of. When we think about how we prevent cancer and when patients do develop cancer, how we improve the treatment of cancer, all that comes from clinical trials.
Why are clinical trials so important? When you think about all the new technologies and drugs and procedures that are really have come about over the last several decades, those all have to be studied in clinical trials to know whether or not those new drugs or procedures or preventative measures are better than what we've done before.
When you look at cancers, even in the highest stage, stage 4 metastatic disease, being potentially cured, that have really come through clinical trials. Clinical trials are our ability to use these newer therapies in patients that either are diagnosed with cancer or are trying to prevent cancer. And they give our patients access to the most exciting therapies and cutting edge therapies available.
[00:03:57] Speaker D: Yeah, I totally agree.
A lot of my patients will come in, especially with rare diseases, and they'll have googled and they'll have looked for, how do you treat my cancer? Or is there a hope for a cure for my cancer? And in the setting of metastatic sarcomas, I mean, this is a really tough type of cancer to treat.
And so what I tell patients about clinical trials are this is really where the hope is. Like, you know, what we've tried in the past hasn't necessarily worked for everyone. That's why we can't cure certain types of cancer. But the point of a clinical trial is, like Dr. Liu said, really, this is the cutting edge. This is the hope for the future, where new treatments or new combinations of treatments or new ways to pick patients who might benefit from treatment, all of those things are getting studied. And so I think that's really what we're hoping to accomplish, accomplish with clinical trials is to give patients a chance for that hope and to be a part of what the future may bring as the new standard of care.
[00:05:01] Speaker C: And all of that sounds so positive and promising. And yet I think there are some misconceptions around clinical trials. Right.
What are some of the biggest misconceptions and how do you address concerns that individuals may have about safety and effectiveness and those kinds of things?
[00:05:22] Speaker A: I think that a lot of people are worried whenever they enroll into a clinical trial that they automatically become a guinea pig for some therapy that is potentially very dangerous or maybe even has no chance of working. Another big misconception is this idea that you're going to get a placebo. What if I get a fake drug?
I think that it's important, particularly in cancer, to understand all the work that goes into developing a drug or procedure for a clinical trial. It is an amazing amount of work that happens before a clinical trial is initiated to ensure what? Number one, that there's a really good chance that this drug will be effective against a particular type of cancer.
Number two, that it'll be potentially safe with a known side effect profile even before we start the clinical trial.
And then, number three, I think that this conception or misconception that most of these trials have placebo. Dr. Wilkie and I will tell you a vast majority of our clinical trials don't have placebo. In fact, a lot of times it would be unethical to provide patients with no drug in certain settings. And so we certainly want people to have the security of knowing that when we run a clinical trial, there's likely been about 4, 5 to 10 years of work leading up to that clinical trial before a drug even hits a patient. That we're doing this because we believe that what's being investigated is much more or has the potential to be much more effective than what we've done over the last several years as what we consider to be standard of care. And Dr. Wilkie gave you a really great example of we got to do better than standard of care. That's the hope of clinical trials and that many of our trials, if, if not almost all of them, either rarely or may never have a placebo. So you're likely to get an active drug.
[00:07:12] Speaker C: Today's episode is brought to you by Lilly. Cancer changes lives. Clinical trials can change cancer. To learn more, visit cancerclinicaltrials.lilly.com that's cancerclinicaltrials.lilly l I l l y.com.
[00:07:32] Speaker D: Yeah, I think historically there's this impression that a clinical trial is for when there's no other options, right? When you've tried absolutely every standard treatment that's out there and you're really on, like you're, you know, the last lines and that's the time to consider a clinical trial. And that's really just not true anymore, you know, so, so explaining to folks that actually now, you know, some of our most exciting trials are first line, so, like, you've been newly diagnosed, there may be clinical trial options where, you know, the, the possibilities are you get a, you get the standard of care, you get our best known treatment, but then you get, or you could get the standard of care plus something new or plus something extra. I mean, that's the perfect kind of study to think about participating in, particularly if you're, if you're early on.
And yes, just to echo what Dr. Liu said, you know, we are doing so much better in the laboratory now about something called targeted therapies or rationally designed therapies, where now we understand, like how drugs might work better. This is not just standard chemotherapy. That's the bomb that kills everything that grows fast. Like maybe this is a drug that's designed to go after pathway X, which might have been shown to be really, really important in a particular type of cancer, or sometimes even in that particular patient's cancer based on genetic testing or some of the new technologies that we have. So it's just important to realize that not all trials are created equal, every TR a little bit different, and to really just, you know, get as much information as you can.
[00:09:06] Speaker C: Well, you've clarified a misconception for me because I am one of the ones who thought it was last line. So thank you both very much for sharing that.
So what advice do you give people or what do you give someone listening who's unsure whether a clinical trial is the right option for them?
Dr. Wilkie?
[00:09:26] Speaker D: Sure. Yes. So exactly. I tell people, basically when I first meet someone, we spend a lot of time going through, you know, what do we know about your particular type of cancer, and then what do we know about you, you as a patient and how that fits with your cancer that we're dealing with. And we talk about the different options, and so we always will go through, okay, this is what we would offer as, again, sort of these standard of care options. This is what we know has X amount of effect or what we think may be helpful for you and what we've done historically or what the standard practices now.
And then, you know, the, the clinical trial options we do go through, you know, what is the information that's led to this clinical trial being designed? You know, what do we know from animal studies or laboratory studies or even patients that may have already been treated in earlier parts of the study?
You know, and this is, this is sort of like where we're coming in and how this might fit in for you.
But a lot of it is, it's a big commitment too. And I think, you know, understanding what's most important to the patient, like, are they someone who is willing to maybe commit a bit of extra time and logistics and to following the schedule that's laid out with a clinical trial.
Many trials come with optional or even sometimes mandatory extra biopsies or blood draws. And so, you know, those are parts of a trial so that we can learn, but maybe a bit more than what a patient is willing to invest or commit at that point. So I think the biggest piece of advice advice is just, you know, really understanding, you know, what's important to, to you as a patient. What do we know how much data is informing the clinical trial option that you have. And then do those things make sense? Do they intersect together?
[00:11:16] Speaker A: I think that's great advice. I, I want people to always understand that they remain in control. One of the concerns about enrolling onto a clinical trial is like, you kind of signed this long document. You worry, well, gosh, does. Does this mean that I'm, you know, losing control? And we really want to reassure everybody that when you do sign up for a clinical trial, you have the ability to drop out at any time if you determine that it's not right for you. So, you know, you remain the boss. Right? We work for the patient, not the other way around. And then the second thing is to understand that many times, and I think that I hope that this is all the time, physician will not offer a clinical trial to a patient unless they really do think it's in the patient's best interest. Now, that doesn't mean you have to do it. It just means that you have a caring physician who really wants to make sure that you have all your options available to you and to trust your gut. Right? I mean, there's something. We want our patients to feel comfortable when they're on clinical trial, that they are doing something that has the potential to really benefit them. And also, second, and certainly just not the most important thing, and I know we'll get to this, but you will also help advance the field. But the most important thing is to do a clinical trial because you feel like it's the right thing to do for you and that you feel like you want to have this potential to have a better outcome because you're on this clinical trial and to trust your gut with that.
[00:12:36] Speaker C: And I'm going to ask one more question since we have a couple of minutes here. So someone's considering a trial, they're considering whether it's the best for them.
Are there resources or support systems that they can look to while they're considering it and. Or while they're currently involved? Like, Dr. Liu, you just said you don't have to stay in it, but are there resources available for them to consider whether staying in it is the best option or whether getting out of it? So both before and during, I think.
[00:13:08] Speaker A: It'S always tough with a clinical trial because one of the most common questions that we get is, well, what have the results been so far? And unfortunately, that's part of the reason why we're doing the clinical trial. If we don't have those results, I think that there are times where a provider, like a physician or advanced practice provider can provide some data in terms of, well, how has the toxicity been? And it's a fair question to say, hey, is there any preliminary data on this drug or combination of drugs? And sometimes there is Right. And so I think that that is number one, a great question to ask. You can also, you know, go onto the Internet and actually at least find out more about the mechanism of action of the drug and see what's been out there. But oftentimes there's not as much information as I think people would want. And so we know one of the biggest pieces of advice is, well, you know, ask your doctor these questions. Even if there aren't great answers, you may get a little bit more information about the clinical trial.
[00:14:06] Speaker D: Yeah, the other thing, I would just say sometimes it comes down to logistics as well. So, you know, at Colorado, we actually serve a huge catchment area, and for rare sarcomas, we run clinical trials that might only be offered here. And the closest center might be California or Texas or something like that. So, you know, in our studies we've had patients traveling from Montana or New Mexico, and some of these folks are coming every couple weeks for treatment. Right. So one of the most wonderful things that can happen is some of these patient foundations and advocacy groups actually have dedicated funds to help support patients who are either traveling for a second opinion to be evaluated for a clinical trial or even some assistance. Assistance, things like Life Flight, which are volunteer pilots who help to offer either discounted or sometimes even free airline support so patients can travel back and forth to be able to get to studies. And many companies offer some reimbursement and support just for the expenses of somebody being able to take advantage of a clinical trial. So I try to make those resources known for patients as well because sometimes those are big factors that may affect someone's decision to participate or not.
[00:15:20] Speaker C: Definitely. I hadn't thought of logistics across state lines and things like that. Well, thank you both so much for participating in episode one of this two part series.
And we hope that those of you listening will come back and join us for episode two.
Thank you for listening to this episode of Campfires of Hope Living Beyond Cancer. For more information about Epic Experience and our programs or to donate, please visit our
[email protected] Music for this podcast is provided by Moonshiner Collective. If you enjoyed this episode, please rate and review us so we can share our story with more people. Also, be sure to subscribe wherever you get podcasts so you'll know when new episodes are released. We hope you come back and join us for our next episode.
