Julie M. Vose, MD
1 First, congratulations on your 2015-2016 ASCO presidency! Can you tell us a little about the theme you selected for the duration of your presidency, Collective Wisdom: Patient-Centered Care and Research? Specifically, how can cancer research and access to clinical trials be made more patient-friendly?
DR. VOSE: My theme has two aspects to it. The first one, “collective wisdom,” is meant to encompass the multidisciplinary team approach that is needed for patient diagnosis, treatments, and follow-up care. The second aspect is patient-centered care and research. The thought behind this theme is to bring us back to the notion that everything we do in oncology is for the patient. Some ideas for making clinical research more patient-friendly are to streamline the ability to get protocols open and available for patients, expand the centers that have access to clinical trials, simplify and make the eligibility more similar to the patient population with the malignancy being studied, and to get the information out to the physicians and patients on what trials are available to them. I hope we can implement some of these changes soon to help our patients get enrolled in clinical trials more quickly.
2In addition, you mentioned in a previous interview with the ASCO Connection that it’s a priority to make sure that we’re investing wisely in cancer research. Can you talk more about what that means and how this can be accomplished?
DR. VOSE: It is very important to spend our research dollars where they will make the biggest impact. Federally funded research has unfortunately been cut back due to budgetary matters in recent years, so advocating for increased federal funding for cancer research and to streamline the process to improve efficiency is crucial. It is also necessary to try to diminish excess regulatory work that does not add to the research information and increases the overhead for the trials. Enhancement of the process involved in clinical research needs to be done through consensus, which will be done through a “Research Best Practices” meeting, set to be conducted by ASCO in 2016.
3Relatedly, a lot of the conversations and presentations at the ASCO meeting this year centered around the cost and value of cancer care and treatment options, specifically some of the newer targeted therapies, which are sometimes prohibitively expensive. How do you think this is going to affect the way oncologists treat their patients going forward?
DR. VOSE: Physicians and patients will need to be very actively involved in evaluating options of therapies for their malignancy. The ASCO Value Framework (http://jco.ascopubs.org/content/early/2015/07/08/JCO.2015.61.6706) that was recently published is a way for physicians to interact with their patients at the point of care to provide information on side effects, efficacy, and the cost of the agents to the patient. We will all need to be much more informed about this information for the individual patient than we have been in the past to help with the value comparison.
4 Do you think educational/informational oncology outlets will need to provide more information about cost and value in order to keep up with the increasing interest in this topic?
DR. VOSE: Although this information is important, it needs to be put into the proper context with a specific treatment. The Value Framework is meant to only compare information from randomized clinical trials. We should also try to encourage investigators to include a pharmacoeconomic component to clinical trials. Hopefully with this increased emphasis, future clinical trials will have this built into their structure from the start.
5What research in the field is exciting you the most right now?
DR. VOSE: I think the most promising area for many malignancies is immuno-oncology. The checkpoint inhibitors alone, or perhaps in combination with other pathway agents, may revolutionize the therapy for a number of cancers. As we review the results of the early trials, it will be easier to understand which malignancies and what combination therapies are the best to take forward into large-scale trials in different tumor types. The next decade of research in cancer care seems very bright for our patients!