Dr. Suneel Kamath, a gastrointestinal medical oncologist at Cleveland Clinic in Ohio and an assistant professor of drugs on the Cleveland Clinic Lerner School of Medication of Case Western Reserve College, sat down for an interview with CURE.
In the course of the dialogue, he defined the important thing takeaways for sufferers from the
CURE: What key message ought to sufferers take away from the 2026 ASCO Gastrointestinal Cancers Symposium?
Kamath: Just like the part 3 HERIZON-GEA-01 trial, what’s actually the general theme of those is that now we have to determine particular biomarkers for as many individuals as we are able to, as a result of after we determine a particular biomarker driving a most cancers, we all know that the efficacy of the medication we use to deal with that focus on shall be a lot larger.
Typically on the flip facet, we are able to have a significantly better facet impact profile in contrast with an untargeted therapy like chemotherapy and even a few of the extra aggressive immunotherapies. We usually consider these as an enormous advance, however a few of these really may be fairly poisonous as a result of they aren’t as focused in sure settings. Having a focused, biomarker-driven method can actually enhance each outcomes and tolerability. It’s upon us to attempt to push that envelope, determine extra biomarkers, in order that we are able to reduce down the variety of folks for whom we solely have untargeted therapies.
KRAS mutations are widespread in pancreatic and different cancers. Are you able to talk about the importance of KRAS testing and different rising focused therapies?
One other one which’s on the horizon, we’ve identified concerning the KRAS gene for a very long time as a extremely essential driver mutation in quite a lot of cancers, an important being pancreatic. Over 90% of pancreatic cancers have KRAS mutations. However solely not too long ago have we been capable of develop medication that may really goal that. That’s actually thrilling. It’s not a uncommon biomarker. If we had an efficient drug for this gene, that will be an efficient remedy for greater than 90% of individuals with pancreatic most cancers, and that would actually be an advance. With extra time, the hope is that we begin to determine extra targets in order that we are able to personalize therapies for each particular person affected person and each particular person tumor, slightly than counting on untargeted regimens.
This additionally emphasizes the significance of doing that testing. It’s nonetheless one thing that we lag behind in, in an enormous means, particularly in the case of getting outcomes on each affected person with superior illness. Now we have to do it in everybody. We might imagine we’re doing a fantastic job, however as physicians, we actually have to work on that. Sufferers will also be sturdy advocates for this. There have actually been conditions the place folks got here in and requested whether or not a particular check had been completed, and it turned out it hadn’t.
Initially, there was an assumption that there wasn’t sufficient tissue or that there was some cause it couldn’t be completed, and it turned out that there was. Folks asking about it has helped result in that testing being accomplished. Sufferers are inspired to be their very own advocates and assist remind clinicians to do the issues they’re alleged to be doing, too.
How do you deal with affected person considerations on the subject of scientific trial participation? What would you like sufferers to grasp concerning the potential advantages of the expertise?
The most important factor I all the time attempt to emphasize for folks concerning scientific trials within the most cancers area is that you’re by no means going to be a “guinea pig.” That’s typically a worry many individuals have, and it is rather comprehensible. In most cancers scientific trials, lively therapy is all the time given; sufferers obtain at the least the routine normal of care that we offer right this moment. You aren’t going to get much less therapy than it is best to; there may be actually solely the chance to probably get extra. I might view it by that lens, that it’s a potential benefit, actually.
The opposite factor I might emphasize is that whereas it’d really feel very new or like you’re taking an enormous danger, I all the time wish to remind folks that each medicine we use right this moment was initially studied in a scientific trial. Earlier than the FDA permitted these therapies, some folks had entry to these medication years earlier than anybody else as a result of they participated in a trial. So, whereas it actually feels dangerous and scary in some ways, it’s typically an effective way for folks to get entry to newer therapies earlier than they’re in any other case out there.
I additionally emphasize that being in a scientific trial isn’t a coercive scenario. If at any level it now not is smart for you, you possibly can pull out at any time. Typically, as of late, we’re designing these trials in an effective way the place there may be normally some kind of biomarker or a very good rationale for why a drug will work in a sure illness or for a sure particular person. I might very a lot encourage folks to search for scientific trials. I feel it’s typically a pathway towards dwelling longer and having higher outcomes. We undoubtedly want to attain that for folks right this moment, whereas additionally studying how we are able to do issues higher for tomorrow.
Transcript has been edited for readability and conciseness.
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