The most exciting clinical developments in cancer care: 5 oncologists weigh in

Five oncologists discuss key clinical innovations that are helping advance cancer care.

Editor's note: Responses have been edited for clarity and length and are presented alphabetically.

Question: What is the most promising clinical innovation in cancer care today?

Craig Bunnell, MD, CMO of Dana-Farber Cancer Institute in Boston

The field of cancer therapy is being transformed by our deeper understanding of the genetic basis of cancer and the interactions between cancer and the immune system. This understanding has allowed us to both personalize cancer therapy, targeting a patient's specific cancer, and to harness the patient's immune system to recognize the cancer and augment its efforts to attack it.

In contrast to historic cancer therapies, like chemotherapy, which are nonspecific and more indiscriminate in their approach, these newer therapies are far more tailored to the patient's particular cancer, making them both more effective and frequently less toxic. This new understanding is the underpinning behind personalized cancer vaccine development, CAR-T therapy and immunotherapy.

With these new, innovative treatments, cancers that were once invariably and rapidly fatal are now being effectively treated, and even cured, and the insights we are gaining are becoming widely applicable to many types of cancer.

Giulio Draetta, MD, PhD, chief scientific officer at the University of Texas MD Anderson Cancer Center in Houston

The development of effective cell-based immunotherapies in oncology represents one of the most compelling innovations we have seen in recent years. We experienced many of the earliest results of cellular therapies firsthand. Clinicians from MD Anderson's lymphoma and myeloma center and stem cell transplantation and cellular therapy center led several of the pivotal trials that led to FDA approval of CAR-T therapies.

Now, many of our researchers are working in tandem with our therapeutics discovery division to develop new experimental cellular therapies, including tumor-infiltrating lymphocytes, CAR NK cells and next-generation CAR-T cells. Our biologics development team has recruited experienced professionals in this field and recently acquired an industry-scale cell therapy GMP manufacturing facility to accelerate these efforts. Recognizing their potential to improve outcomes, lower side effects and reduce barriers to treatment, MD Anderson is committed to advancing next-generation cell therapies for our patients.

Nikhil Khushalani, MD, vice chair, department of cutaneous oncology and assistant center director, clinical research review and partnerships at Moffitt Cancer Center in Tampa, Fla.

I believe the most promising clinical innovation in cancer care today is precision immunotherapeutics. I envision this will help us clearly match a patient with a given cancer to the right immunotherapy agent that will enhance the chance for success in terms of improved efficacy and/or mitigation of toxicity. We have seen the success of immune-checkpoint blockade (like anti-PD1/PDL1 or anti-CTLA-4 agents), CAR-T therapy and TIL (tumor infiltrating lymphocyte) therapy across various cancers. Several of these modalities are already FDA-approved. But the key is now priming them for optimal success, which is where precision immunotherapeutics will play a role.

David Maloney, MD, PhD, medical director of cellular immunotherapy for Seattle Cancer Care Alliance

CAR-T therapy continues to be one of the most exciting clinical innovations we see in cancer care. What was considered to be science fiction when it first appeared, CAR-T is a unique approach to cancer treatment that involves reengineering a person's cells so that those cells can fight the individual's cancer. CAR-T moved quickly from experimentation to treatment, offering new options for patients with several difficult-to-treat cancers. Today, three CAR-T treatments have been approved by the FDA, and with this momentum, we are already testing CAR-T in clinical trials at earlier points in treatment for certain cancers.

While CAR-T is complex and cannot yet be offered broadly, cancer centers like Seattle Cancer Care Alliance that are able to provide these therapies are offering hope for a cure for many people whose options for cancer treatment were limited. We are excited to see this field continue to grow.

Alan M. Miller, MD, PhD, chief medical director of oncology and associate chief medical director of clinical research at SCL Health in Broomfield, Colo.

Immunotherapy has been the most significant clinical innovation in cancer care in the last five years. Engaging the body's own immune system, in addition to or in place of chemotherapy, has led to prolonged survival and increased cures in several malignancies.

More articles on oncology:
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No. 1 for cancer care: What's missing from rankings for this specialty?

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