Tag Archive for: endometrial cancer clinical trials

Questions to Ask About Endometrial Cancer Clinical Trials

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What questions should patients ask about endometrial cancer clinical trials? Dr. Hinchcliff outlines key inquiries regarding trial structure and eligibility and encourages patients to explore online resources and support groups for additional information.

Dr. Emily Hinchcliff is a Gynecologic Oncologist at Northwestern Medicine. Learn more about Dr. Hinchcliff.

See More from Evolve Endometrial Cancer
 

Related Programs:

Current Endometrial Cancer Treatment Approaches
Advances in Endometrial Cancer Treatment and Research
 Where Do Clinical Trials Fit Into an Endometrial Cancer Plan?

Where Do Clinical Trials Fit Into an Endometrial Cancer Plan?

Transcript:

Katherine Banwell:  

What questions should endometrial cancer patients ask their doctor about a potential trial? 

Dr. Emily Hinchcliff:  

I think the two important things to ask are what is the structure, what am I actually going to get, or what could I get, depending on how many of those arms exist on the trial. 

Katherine Banwell:  

Would the doctor know that specific information, though? 

Dr. Emily Hinchcliff:  

It’s a good question, actually. So, generally speaking, most of us as physicians, in order to offer a trial to you, we have an overarching structure of that clinical trial. There may be some nuances about what the exact enrollment is in terms of the majority of the patients get this treatment, whereas a small minority get this treatment, or because of this patient’s specific mutation profile, they must be enrolled on this subset of the trial. 

So, there are some nuances there that, generally speaking, if I as the physician don’t know, I will contact what’s called my clinical trial coordinator or my research nurse, and they can come spell out some of those nuances, but if your doctor’s recommending a trial to you, they generally know what is the overarching goal, and what is the overarching treatment being tested. 

Katherine Banwell:  

Okay. How can patients learn more about clinical trials? 

Dr. Emily Hinchcliff:  

So, there are a lot of resources online. To some extent, it can be really overwhelming for patients to try and tease out am I a candidate, would I be eligible for a trial, or this trial, is this trial available at my institution. So, what I would say – first and foremost, ask your physician. I think that your physician is your advocate in this and your partner in your cancer care, and I think that certainly I and all of us as physicians feel really strongly that we can help you weigh those different options as you see them and as we learn about them.  

So, I think that that’s where I would start. I think there are a lot of online resources. The FDA and the government have a cancer trials website that you can go to and search for your specific cancer type. 

Many institutions – my own included – will have their own institutional trials website, where, on my institution, you can look up and see what trials do we have open on my institution, because obviously, the government will speak nationally, but your particular treating physician might not have the availability to give you that particular trial. And then, I also will say I think patient support groups are an incredible opportunity to understand what others have been going through and what treatments have been offered, and that can be a really helpful resource as well to get hooked into as a patient is trying to tease all this out. 

Where Do Clinical Trials Fit Into an Endometrial Cancer Plan?

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What role do clinical trials play in endometrial cancer treatment plans? Dr. Hinchcliff highlights that clinical trials can be crucial at every stage of the cancer journey, offering access to innovative therapies and alternatives to standard care. 

Dr. Emily Hinchcliff is a Gynecologic Oncologist at Northwestern Medicine. Learn more about Dr. Hinchcliff.

 
See More from Evolve Endometrial Cancer
 

Related Programs:

Current Endometrial Cancer Treatment Approaches
Advances in Endometrial Cancer Treatment and Research
 Questions to Ask About Endometrial Cancer Clinical Trials

Questions to Ask About Endometrial Cancer Clinical Trials

Transcript:

Katherine Banwell:  

Dr. Hinchcliff, where do clinical trials fit into a treatment plan for endometrial cancer? 

Dr. Emily Hinchcliff:  

So, I think clinical trials are an incredibly valuable part of a patient’s cancer journey. Every institution and every provider is going to have potentially different clinical trials available to the patients in their practice, and so, it’s important to understand what clinical trials might be available to a patient as they both start their cancer journey, but certainly as their cancer progresses or comes back. 

I think that there is – it should be something that is on the back of your mind at all phases of a cancer journey. It may not be right for a patient if they are first diagnosed and have a clear standard-of-care option, but there are certainly clinical trials that add to or investigate what we consider to be the current standard of care to try and move that forward. So, even in that first diagnosis phase, I think it’s worth asking your doctor, “What’s available to me?” 

And then, certainly, when a cancer comes back, especially when a cancer has developed resistance to some of the more standard options that we would use, then I think clinical trials are an incredibly – it’s an incredible opportunity to have access to a toolbox that you would not have access to otherwise. And so, I think that – when I think about clinical trials, I think that they fit into all phases of a cancer journey, but that there are certain times in every individual patient’s journey that I would say this clinical trial might be right for you at this particular time. 

Katherine Banwell: 

What would you say to patients who are hesitant about trial participation? 

Dr. Emily Hinchcliff:  

So, I think that that is very common, and what I would say is information is power. I think that if there is a trial that you are eligible for, it’s really important to understand what the actual structure of that trial is and also understand what the phase of that trial is. So, let me explain those two things, because I think they’re a little bit different. 

When I think about a trial structure, I think about what is the trial testing, what is it looking at, and what are the potential arms of therapy. When we say “arms,” that just means what is a patient going to actually receive. And so, some trials, there’s only one option. Anyone who’s enrolled on the trial gets a certain thing. Other trials have some comparison arms. So, some patients that are enrolled get a certain treatment; some patients that are enrolled get a different treatment. 

And so, as you think about the structure, it’s important to know what might I get? Am I always going to get the treatment arm – for example, the drug that’s being investigated – is there a placebo arm – an arm that says I might get something that’s standard, like chemotherapy, but I’m going to get chemotherapy plus a placebo, which means an inactive agent, as compared to chemotherapy plus an inactive drug. 

So, it’s really important to understand the structure of a trial. The second thing that I think is important to understand is the phase. So, clinical trials are grouped into phases. Phase I, Phase II, Phase III are the most common that you’ll hear about, and those are a description of how far along is that particular drug or treatment in development. 

So, Phase I, that treatment is very early. It does not mean that there’s not promising data around it, but it means that that drug doesn’t have data, for example, in lots and lots of patients with your particular cancer type, right? Instead, usually, a Phase I trial is looking at a drug in humans or in a particular group of tumors – or patients with a particular group of tumors – for the first time or early on. 

Phase II trials are looking at that drug maybe a little bit later, after they’ve gotten some good data, or trying to expand a drug that might have been used in a different cancer type to a new cancer type, for example. And then, Phase III is the bigger studies where you’re looking to enroll more patients in a specific cancer type for a specific reason to say, “Okay, we’ve had good evidence that this drug has some amount of efficacy, so now we’re really trying to look to see how does it compare to what we have out there, and could this help us move forward?” 

Advances in Endometrial Cancer Treatment and Research

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What new developments in endometrial cancer treatment should patients know about? Dr. Hinchcliff highlights advancements in immunotherapy for newly diagnosed patients and ongoing clinical trials focusing on molecular pathways and drug combinations for more personalized care. 

Dr. Emily Hinchcliff is a Gynecologic Oncologist at Northwestern Medicine. Learn more about Dr. Hinchcliff.

 
See More from Evolve Endometrial Cancer
 

Related Programs:

Current Endometrial Cancer Treatment Approaches
 Where Do Clinical Trials Fit Into an Endometrial Cancer Plan?

Where Do Clinical Trials Fit Into an Endometrial Cancer Plan?

 Questions to Ask About Endometrial Cancer Clinical Trials

Questions to Ask About Endometrial Cancer Clinical Trials

Transcript:

Katherine Banwell:  

Are there endometrial cancer treatment developments that patients should know about? 

Dr. Emily Hinchcliff:  

Yes. So, I think within literally the past year/two years, we’ve had some truly groundbreaking work that has changed the way all of us practice in GYN oncology, and that is specifically around this immunotherapy. So, it used to be that we would save immunotherapy for when someone’s cancer had returned. So, they would get their initial, for example, chemotherapy if they needed it, and then, when the cancer came back, that’s when we would start thinking about immunotherapy. 

There are now two big randomized controlled trials, which is sort of our best data, that tells us that adding immunotherapy in the first line, meaning when someone is first diagnosed, if their cancer has spread outside the uterus, that adding immunotherapy at that point can be really helpful for certain patients, and so, I would say that as an avenue of treatment – understanding is immunotherapy right for me, why or why not – is kind of my second takeaway for patients. 

Katherine Banwell:  

You mentioned trials. Are there ongoing trials that are showing promise? 

Dr. Emily Hinchcliff:  

Absolutely. I think it is an incredible time to be a GYN oncologist because the field is advancing so rapidly. 

I think that now, we are really focused on some of these molecular pathways to try and not only understand which patients should we be giving these therapies to, who are they most effective in, which patients can we actually be pulling back, who has a better prognosis, so we may not need to give them the toxicity level that comes with all of the standard chemotherapy options, and then, also, are there drug combinations that may work better for patients, and how do we choose which combination therapies we should use. And so, I think that there are a lot of really exciting clinical trials going on in endometrial cancer right now. 

Katherine Banwell:  

Dr. Hinchcliff, what areas of research are you focused on? 

Dr. Emily Hinchcliff:  

So, I have spent a lot of my research time working in immunotherapy. As you can tell, I’m pretty jazzed about it. I think it really has changed the game in terms of cancer care. And so, a lot of my work centers around the use of immunotherapy in gynecologic cancers. 

I also am very interested in looking at how we can better understand a cancer’s response to treatment. As we give treatment, often, endometrial cancer doesn’t have an easy blood test to say, “My cancer’s getting better,” so we kind of have to wait until we get a CT scan, which we usually do three months apart, and so, there are some newer blood tests out there that we’re trying to understand how to use and how to best leverage for our cancer patients, and that allows us to potentially switch treatments sooner if something isn’t working, or choose a better treatment up front, depending on which test we’re looking at. So, that’s really where my research centers. 

Katherine Banwell:  

Is there anything you’d like to add about the evolution of endometrial cancer care? What are you excited about? 

Dr. Emily Hinchcliff:  

I think I am really excited that our field has made this big switch to focusing on some of these molecular aspects. It has always been so hard to treat all endometrial cancer with one hammer-and-nail-type pairing, and now we’re able to be a little bit more nuanced with our tools, and that’s always a really exciting place to be. I also think that it’s really important to highlight some of the disparities that still exist in endometrial cancer, and honestly in cancer more generally, and I think that we as a field are starting to really highlight that and understand – or at least try to understand – how can we better provide care to every single patient who is diagnosed with an endometrial cancer. 

Advancements in Endometrial Cancer Trials | Insights and Opportunities

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Advancements in Endometrial Cancer Trials: Insights and Opportunities from Patient Empowerment Network on Vimeo.

What’s important for endometrial cancer patients to know about clinical trials? Expert Dr. Charlotte Gamble from MedStar Health discusses novel therapies under study, treatments that are showing promising results, and patient advice on clinical trials.

[ACT]IVATION TIP

“…be able to ask your doctor about if you’re eligible for clinical trials, what your cancer mutational or genetic code is that might make you eligible for certain clinical trials, and where those trials are offered, if it’s at the health system that you are seeking care, or if it’s at a nearby health system, if you’re able and willing to travel.”

Download Guide | Descargar Guía en Español

See More from [ACT]IVATED Endometrial Cancer

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What Are Barriers to Endometrial Cancer Care Access?

What Are Barriers to Endometrial Cancer Care Access?

 Should Some Gynecologic Cancer Patients Seek a Specialist?

Should Some Gynecologic Cancer Patients Seek a Specialist?

 Are Beauty Products a Risk Factor for Endometrial Cancer?

Are Beauty Products a Risk Factor for Endometrial Cancer?

Transcript:

Lisa Hatfield:

So, Dr. Gamble, this is kind of a three-part question about clinical trials. Can you talk a little bit about ongoing clinical trials that are investigating novel therapies for advanced endometrial cancer? And then maybe talk a little bit about some promising or encouraging results that you’re seeing with trials? And last part of the question is, what do you want people living with endometrial cancer to know about clinical trials?  

Dr. Charlotte Gamble

I’m so glad you asked this question. This is such a valuable question and an area of a lot of interest that has improved over the past several years, not only about clinical trials and the real need to make sure that patients are aware of them and to ensure that these clinical trials represent the populations that we intend to serve as healthcare providers in the United States, but also specifically in the world of endometrial cancer. Really exciting, promising results that we’ve had over the past year, year-and-a-half specifically that address the very desperate need for novel therapeutics to treat patients who have endometrial cancer.

So, for example, two major trials were published last year, presented at international meetings, looking at the real improvement in overall survival, really increasing the length of time patients can live with endometrial cancer that leverage the use of drugs called immunotherapy. So things like dostarlimab-gxly (Jemperli) or pembrolizumab (Keytruda), these are generic names for immunotherapy drugs that work very well in some subsets of patients with endometrial cancer.

This is something, some survival benefits that we have never seen before in the endometrial cancer space and rarely seen in the gynecologic oncology space and is a definite marker of huge success in terms of extending the lifespan of patients who suffer from this challenging to treat understudied, underfunded disease. Endometrial cancer is actually one of the lowest funded studies in the National Cancer Institute at NIH.

And so having major trials come out over the past couple of years that really look at survival opportunities with the leveraged use of immunotherapies is something that is both exciting and invigorating to the field and hopefully can potentiate further funding from the NCI to be able to study this disease type. In terms of your question for what patients should know about, about ongoing trials, I think this dovetails into several of the points that we’ll discuss during this interview of making sure that patients are their own advocate and having an advocate nearby and with them at all of their appointments.

 So it’s really important to ask their subspecialists, their oncologists or their gynecologic oncologists about if there are any clinical trials that the patients are eligible for. A lot of this comes down to, has the patient undergone genetic testing or molecular sequencing that looks at the specific mutations in the cancer tissue that sometimes will make patients eligible for certain clinical trials or others? And other times it’s just understanding that what opportunities are available within the health system and outside the healthcare system in which the patient is seeking care.

A lot of times when we see that these trials that are published might not represent a racially diverse group of patients. Oftentimes it’s because of two reasons. One, patients aren’t even offered clinical trials, even if they are eligible. Or two, patients might be getting care at a health facility that doesn’t have access or the infrastructure to enroll them on these clinical trials that could be available, perhaps at a regionally nearby cancer center.

I oftentimes suggest to patients, please ask me questions about your molecular subtyping. Ask me questions about what clinical trials you might be available for. There is a significant amount of trust that the health system needs to earn back from patients to allow them the headspace to trust the health system again, given historical, massive, ethical issues and trials in the past and patients and their loved ones feeling that clinical trials just means a big experiment and they don’t want to be experimented on. And what I often say to that is really, you have to understand the details of the trial and the science going into it and make sure that your doctor has your best interests at heart. But oftentimes these trials hold significant promise.

And the reason that you might be eligible for them is that the trial drugs might work better than standard of care, certainly for endometrial cancer we’ve seen that in the two major trials that came out this year. So I think my activation tip for this question is really to be able to ask your doctor about if you’re eligible for clinical trials, what your cancer mutational or genetic code is that might make you eligible for certain clinical trials, and where those trials are offered, if it’s at the health system that you are seeking care, or if it’s at a nearby health system, if you’re able and willing to travel.

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Which Endometrial Cancer Clinical Trials Are Showing Promise?

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Which Endometrial Cancer Clinical Trials Are Showing Promise? from Patient Empowerment Network on Vimeo.

Which endometrial cancer clinical trials are showing encouraging results? Expert Dr. Emily Hinchcliff from Northwestern Medicine shares insight about novel therapies and combinations and advice for patients to be proactive in their care. 

[ACT]IVATION TIP

“…understand what clinical trials are available to your physician and to you at the place that you are currently getting treated. And then also understand more globally what other clinical trials might be out there. And that’s a great question to ask your physician.”

Download Guide | Descargar Guía en Español

See More from [ACT]IVATED Endometrial Cancer

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Understanding Endometrial Cancer Risk: Factors Influencing Incidence and Mortality

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Endometrial Cancer Care Disparities: The Impact of Rural Residence

 Overcoming Geographical Barriers in Endometrial Cancer Care

Overcoming Geographical Barriers in Endometrial Cancer Care

Transcript:

Lisa:

What ongoing clinical trials are investigating novel therapies for advanced endometrial cancer? And can you provide some insights into any promising experimental treatments that have shown encouraging results in early phase trials?

Dr. Emily Hinchcliff: 

Absolutely. So I think that the use of immunotherapy in endometrial cancer has been a true game changer.  It has changed the landscape of how we think about treating this disease. I think the cutting edge now is to try and understand whether immunotherapy in combination with our more traditional chemotherapy, cytotoxic chemotherapies that basically kill cells rapidly dividing as compared to immunotherapy, which helps to kill cancer cells by using the immune system. So should we be using immunotherapy in addition to, or even instead of some of those traditional chemotherapy options? There are also many, many clinical trials that are investigating novel combinations and novel targeted agents, especially for the high-risk tumor subsets.

So endometrial cancer is a broad umbrella term for many different subtypes. And the higher risk subtypes often are those that are harder to treat with our standard therapies. And so many trials are specifically trying to target better options for these patients. I think that one trial that I will just highlight in addition to some of the immunotherapies are immune therapy combinations with what are called anti-angiogenics. So drugs that try to prevent the tumor from growing its own blood supply.

And then also immunotherapy in combination with another class of drugs called PARP inhibitors which are more commonly used in ovarian cancer but which in combination with immunotherapy may be a new avenue for effective treatment.

Lisa:

And do you have an activation tip for patients for that question?

 Dr. Emily Hinchcliff:  

Absolutely, so I think that my activation tip for patients surrounding novel therapies in endometrial cancer is to understand what clinical trials are available to your physician and to you at the place that you are currently getting treated. And then also understand more globally what other clinical trials might be out there.

And that’s a great question to ask your physician. I think that your physician can help you to decide is a standard of care therapy the right choice for you at this point in your treatment, in your cancer journey, or are you at a point where a clinical trial may be of benefit either because of the expected efficacy of the standard of care, or because of the potential benefits of that clinical trial, or even because of the side effect profiles of either of those options.

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What Endometrial Cancer Patients Should Know About Clinical Trials

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What Endometrial Cancer Patients Should Know About Clinical Trials from Patient Empowerment Network on Vimeo.

What do endometrial cancer patients need to know about clinical trials? Expert Dr. Ebony Hoskins explains the importance of clinical trial participation for all patients and shares advice for patients to improve their clinical trial access. 

Dr. Ebony Hoskins is a board-certified gynecologic oncologist at MedStar Washington Hospital Center and assistant professor of Clinical Obstetrics and Gynecology at Georgetown University Medical Center.

[ACT]IVATION TIP

“…asking their provider, one, are clinicals trial offered at their institution. And second, if it’s not offered at the institution, do you think that, are there any other institutions that may offer trials for the patient?”

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Emerging Endometrial Cancer Treatments _ Promising Data and Challenges

Emerging Endometrial Cancer Treatments | Promising Data and Challenges

 Endometrial Cancer Treatment Options for Patients to Consider

Endometrial Cancer Treatment Options for Patients to Consider

 What is the Role of Immunotherapy in Endometrial Cancer

What is the Role of Immunotherapy in Endometrial Cancer?

Transcript:

Mikki:

Dr. Hoskins, why is clinical trial participation so important in endometrial cancer? What advice do you have for patients considering a clinical trial?

Dr. Ebony Hoskins:

So I think clinical trial participation is important in endometrial cancer. Number one, the rate of Black women getting advanced and aggressive endometrial cancer is on the rise. The representation in these trials are different. What’s different is not only the patient, the tumor type is different. How do we know that these same patients that’s not in the trials are going to respond to this treatment? That’s what I always ask. I’m like, maybe they don’t respond as well, because that’s a different disease type, right?

So we recently looked at a trial where most of the patients had an endometrioid type of endometrial cancer, whereas I, in my practice, I see a lot of Black women who don’t have endometrioid type. They may have a serous type, which is a more aggressive type or a carcinosarcoma. So I don’t know if I can really apply that to this, to that the medication.

That’s all I have, but how do I know that she’s going to respond in the same way? So I think it’s definitely important. I recently had a patient that I referred to a clinical trial. And she really was struggling with whether she should do it or not. And one of the things that I said to her is, “I think it’s important. One, you’re going to have access to advanced treatment options that are not there now.” And I said, also I said, “Not that she has to take it for a whole group, but we need to have more information on the type of cancer you have.” And I was like, “And Black women are dying, and we need this information to know if this is the same.” And she instantly was like, “I’m going, I’m doing it.” And I mean, not that she has to take, but we need to know more. And I think it’s very important that we have patients with access to trials.

Mikki:

Yes. Do you have an activation tip for those patients that you see?

Dr. Ebony Hoskins:

I think asking their provider, one, are clinical trials offered at their institution. And second, if it’s not offered at the institution, do you think that, are there any other institutions that may offer trials for the patient? There are sometimes where patients don’t have the opportunity to travel elsewhere and need to be in their community for work, family, etcetera. So I understand the asking. 

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What Disparities Exist in Treating Patients With Endometrial Cancer?

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What Disparities Exist in Treating Patients with Endometrial Cancer? from Patient Empowerment Network on Vimeo.

What do endometrial cancer patients and advocates need to know about disparities? Expert Dr. Ebony Hoskins shares noted endometrial cancer disparities in care and how patients can take action to ensure their best care.

Dr. Ebony Hoskins is a board-certified gynecologic oncologist at MedStar Washington Hospital Center and assistant professor of Clinical Obstetrics and Gynecology at Georgetown University Medical Center.

[ACT]IVATION TIP

“…I always think it’s important that patients feel that they’re heard by their providers or doctors, feel free to ask any questions and so having that or talking about…we are not going to be able to change the biology, right? But we can change our voice, and we can change making sure the patient is heard, making sure they have a comfortable relationship with their provider.”

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 What Role Does Hormone Therapy Play in Endometrial Cancer

What Role Does Hormone Therapy Play in Endometrial Cancer?

 What Is the Role of Surgery in Treating Endometrial Cancer

What Is the Role of Surgery in Treating Endometrial Cancer?

Transcript:

Mikki: 

Dr. Hoskins, what are the noted disparities seen in endometrial cancer treatment, and what are some of the actions being taken to combat them?

Dr. Ebony Hoskins: 

Well, I mean, first off, we know that Black women are diagnosed pretty much at the same rate as white women, but have a two times higher risk of death. And so that alone is a big disparity. We also see increased, I shouldn’t say increased, but more aggressive tumor types in Black women, and so we know that part. I think in terms of what we’re doing to combat it from a clinical trial standpoint, they, I think some of the clinical trials, have recognized that there is a low number of patients in these trials advancing and so there has been an increased effort in recruiting patients into these trials. I think there is more work being done, to understand the biology and why there’s a difference. Me as a provider I will always think, “Oh, it’s because women went to the doctor late or access to care.”

Dr. Ebony Hoskins:  

And then I’m like, “Well, no, no, no these women have access to care. They have access to insurance. They went to the doctor right away.” And so I think it’s very complex and deserves more study into it. In terms of my activation tips, in terms of disparity, I always think it’s important that patients feel that they’re heard by their providers or doctors, feel free to ask any questions and so having that or talking about…we are not going to be able to change the biology, right? But we can change our voice, and we can change making sure the patient is heard, making sure they have a comfortable relationship with their provider. I think that is important.

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