PHASE 1 AND 2 CANCER RESEARCH: 4 SPECIALISTS SHARE THEIR EXPECTATIONS FOR THE COMING YEAR
Four specialists, working at the center, have shared their expectations for the coming year in this field, highlighting interesting developments regarding medications and changes in the composition of study populations. Additionally, the experts explain how the collaboration between the NKI and other research institutions is set to deepen further.
Promising new drugs
Developments within the antibody-drug-conjugates (ADCs) group have accelerated in recent years, and this is expected to continue in the coming year. In these drugs, a cytotoxic drug (chemotherapy) is linked to an antibody, which ensures that the cancer cells are specifically targeted. The outcome: increased effectiveness and reduced damage to normal cells, which eventually leads to improved prognosis and fewer side effects for patients.
Moreover, improvements in the accuracy of ADC antibodies are anticipated in the near future. The linkers, which bind the antibodies to the cytotoxic agents, are also becoming more and more sophisticated, facilitating a refined delivery of the cytotoxic drug. Lastly, the pharmaceutical landscape is witnessing the introduction of drugs with entirely new mechanisms of action. An example is the ImmTACs, a novel class of fusion proteins where cancer-recognizing T-cell receptors (TCRs) are linked to immune-activating complexes. "Our center is currently conducting a study on such a drug," explains Neeltje Steeghs, head of the Center for Early Drug Development.
"Our center is currently conducting a study on such a drug," explains Neeltje Steeghs, head of the Center for Early Drug Development.
New combinations
Beyond research on ADCs, in 2024 there will be (more) trials investigating new combinations of drugs that are already on the market. These could be promising, especially for individuals with tumours that have shown resistance to current treatments. "In the coming year, we are planning to launch at least two investigator-initiated studies in which new combination therapies will be tested for colon cancer patients," Steeghs adds.
Phase 1 research can start earlier
The eligibility for phase 1 studies has now expanded beyond patients who have completed their treatment regimen. "Now, even patients with metastases might be candidates for phase 1 trials at earlier stages," explains Marloes van Dongen. In fact, it has been observed that immunotherapies are more effective if the patient's immune system is still active."Then we prefer to administer it sooner, in a 2nd or 3rd line, rather than later".
The effects of stricter selection criteria
The criteria for early clinical trial selection are becoming stricter, as advancements enable better prediction of which patients will benefit from certain treatments. While this trend is expected to persist, it does come with an important drawback, as Frans Opdam notes. This is because patients with rare tumours are included at a slower rate than those with tumours for which numerous drugs are already available on the market.
Gerrina Ruiter, phase 1 physician and pulmonologist, is optimistic about the studies for patients with stage IV lung cancer. Through communication with referrers, it is often possible to match patients with a study that aligns with their specific clinical profile.
In conclusion, numerous early clinical trials hold promising potential results for cancer patients. In addition to leading these trials, doctors are actively working to enhance the collaboration with other treatment and research centers. Neeltje Steeghs, for example, has recently taken on the responsibility of initiating the Early Clinical Studies Platform of the national 'Oncode Accelerator' project, aimed at facilitating faster and more cost-effective development of potential cancer drugs. On the other hand, as Principal Investigator at the Cancer Core Europe Network, a collaboration between 7 leading Cancer Centers in Europe, Frans Opdam will focus on enhancing knowledge exchange among the participating institutions.
