Clinical trials can offer additional treatment options for people with cervical cancer—but when is the right time to consider one? Dr. Joshua Cohen explains how trials fit into a cervical cancer care plan, discusses the potential benefits of participation, and addresses common concerns.
Dr. Joshua G. Cohen is a board-certified gynecologic oncologist and Medical Director of the Gynecologic Cancer Program at the City of Hope Orange County. Learn more about Dr. Cohen.
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Transcript
Katherine:
When should cervical cancer patients consider a trial?
Dr. Josh Cohen:
I think for anybody who’s dealing with, unfortunately, a metastatic cancer, meaning that the cancer’s left the cervix, or anyone who’s dealing with a recurrent cervical cancer, meaning the cancer was treated and it’s come back, I think it’s very reasonable to seek out clinical trials.
As I mentioned earlier, the use of immunotherapy is fairly new in the management of advanced cervical cancer, meaning for those patients receiving chemotherapy and radiation combined, we’re now using immunotherapy. We have some new clinical trials that have now been put forth that we are participating in that are now trying to determine, “What is the best route of this treatment? Do patients get chemotherapy by itself for a few weeks and then the chemoradiation with immunotherapy? Do patients go straight to the chemotherapy, radiation, and immunotherapy? Do we start the immunotherapy first?”
And so, these trials do exist, and I would say it’d be helpful, potentially, to enroll in one of these trials. Again, you get the latest and the greatest. You get a study team that follows you. And you’re answering a meaningful question for other women impacted by this cancer. For patients with recurrent cervical cancer, there are new molecules, new agents.
And I think it’s always important to seek out, again, an expert opinion to find out if you’re a candidate for one of these newer drugs that may be approved in the last one to two years for cervical cancer by the FDA. Or, perhaps, there is a clinical trial that you may qualify for.
Katherine:
What would you say to someone who’s hesitant to participate in a clinical trial?
Dr. Josh Cohen:
I would want to understand why they’re hesitant. And I think there are many different reasons for that, and I respect people who may have concerns about randomization. In part, you’re giving control over to a study, meaning that you’re willing to be randomized to one treatment or another, which can be very, very scary.
But in the same respect, the doctors you’re working with should be picking trials that you will have a good treatment regardless of the arm on the trial, if it is a randomized trial. There are some trials where there is no randomization, and we know what treatment you’re going to get. But the art of a clinical trial is to find one that meets your needs and that will give you access to a drug that you may not otherwise see.
And that’s one of the benefits of a trial is that you are getting the latest and greatest drugs that insurance companies may not cover, that may not be available through pharmacy companies because the FDA has not approved it – FDA meaning the Food and Drug Administration – but these are drugs that you don’t want to wait five years for to make their way through the regulatory process; you need it now. And so, there can be a lot of power in having access to these drugs earlier that could be life changing.
In the same respect, your answering an extremely important question for other patients. And some patients who are dealing with a metastatic cancer find that very comforting that no matter what the outcome for them, they’re making it better for other women who may be impacted in the future.