For nearly five months, Christine Snyder traveled from her home south of Syracuse to Wilmot Cancer Institute to participate in a clinical trial. She came every three weeks for treatment as part of a study evaluating whether chemotherapy alone would be as effective as chemo and surgery for recurrent ovarian cancer.
The trial is one of about a dozen that have opened this year at Wilmot through the National Cancer Institute and NRG Oncology, a nonprofit cooperative group that leads clinical research with institutions nationwide. These trials address persistent questions about treatment for a variety of gynecologic cancers, including cervical, endometrial and ovarian, and Wilmot offers the most extensive portfolio of these trials in the region. In addition to these large national treatment trials, Wilmot also offers trials that are available only in Rochester, including one that is evaluating potential molecular biomarkers to predict the risk of a pelvic mass becoming cancerous.
“We’re part of the movement to change the future of gynecologic oncology,” says Sajeena Thomas, M.D., one of Wilmot’s gynecologic oncologists. “It’s phenomenal to offer patients trials that will have a role in shaping what will become the standard of care.”
For many gynecologic cancers, progress in improving survival has been slow, and there have been few advances over the last decade. Researchers are now looking at treatment options beyond chemotherapy, and many of the trials at Wilmot focus on targeted therapies. Unlike chemotherapy — which is relatively indiscriminate in its impact on cells — targeted therapies act on specific genes or other molecules involved in the growth, progression and spread of cancer.
“We’re learning more about how cancers develop, what their weaknesses are and how to exploit them,” says Richard Moore, M.D., chief of Gynecologic Oncology at Wilmot Cancer Institute. “Every day, new targets are identified, as are new drugs that can take advantage of that target,” Moore says.
Among those is a new class of drugs called PARP inhibitors, which block an enzyme in cancer cells that helps repair damaged DNA. These drugs, which are in trials at Wilmot, have shown promise in delaying the recurrence of ovarian cancers among in women who have mutations of the BRCA genes and for those with different genetic profiles.
“Especially at a center like this, it’s important to offer our community cutting-edge care and to allow access to drugs that aren’t widely available,” Moore says.
Although targeted therapies and precision medicine are promising, their very nature means they do not work on every cancer, and scientists at Wilmot are looking for more possibilities.
Moore leads a team in Wilmot’s Targeted Therapeutics Laboratory for Gynecologic Cancers who are developing new molecules that could one day become therapies that leverage different features of tumors. For example, they are focusing on molecules that would counteract a protein called HE4, which is a marker for ovarian cancer.
In addition, this team is part of a clinical trial studying tumor cells circulating the blood of women who have a pelvic mass. The aim of the study is to identify biomarkers and develop a test that uses them to estimate the risk of the mass being malignant. Wilmot is the only site in the U.S. to participate in this study, which is also being conducted in Europe.
Patients like Snyder, whose cancer returned earlier this year, are coming from hours away to participate in these studies.
“Being involved in a clinical trial has been no inconvenience for me by any stretch,” Snyder says. “I firmly believe in the research that goes on and anything we can do to evade cancer.”
Although she had never before considered taking part in a trial, Snyder agreed after Thomas presented the option to her, and Snyder, a tax accountant, has never been one to sit idle.
“You can lay around and bemoan the fact that you’re sick,” she says with a shrug. “Do what you can.”