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The New RU: Clinical Trials

The university is now positioned to deliver every facet of health care, from research to patient care. A key link in the "bench to bedside" chain are clinical trials, where discoveries born of experimental drugs and therapies go on to save lives.

 

 

Cancer survivor Scott Glickman is the founder of Century for the Cure
Cancer survivor Scott Glickman is the founder of Century for the Cure, his nonprofit organization that has raised close to $1 million for the Rutgers Cancer Institute of New Jersey over the past nine years. Photography by Nick Romanenko

Riding High
Saved by a state-of-the-art cancer therapy developed at the Rutgers Cancer Institute of New Jersey, Scott Glickman raises money to finance its research.

In his cycling shorts and red Century for the Cure jersey, Scott Glickman could be just one of the scores of riders who’ve assembled at Camp Riverbend in New Jersey’s Warren Township to raise money for the Rutgers Cancer Institute of New Jersey. Except that for Glickman, 50, the ride isn’t just charitable; it’s personal. In 1997, nine months after the birth of his first child, he was diagnosed with stage IV non-Hodgkin’s lymphoma, a cancer originating in the lymphatic system where tumors de­velop from the white blood cells known as lymphocytes. And it was at the Cancer Institute that he found an oncologist, and a supporting team of practitioners, who gave him the confidence to believe, he says, that “I was going to beat it.”

Glickman’s confidence was rooted in the sense that his oncologist, Roger Strair—the Cancer Institute’s chief of hematologic malignancies and hematopoietic stem cell transplantation—was fully engaged in his treatment, including a three-week course of high-dose chemotherapy, followed by the then-experimental drug Rituxan. Sixteen years later, Glickman remains asymptomatic.

It was no accident that Glickman’s therapy was state of the art. Now affiliated with Rutgers, the Cancer Institute is a leader in cancer research and one of only 41 National Cancer Institute (NCI)-designated comprehensive cancer centers in the United States. Its association with NCI, says director Robert S. DiPaola, allows the Cancer Institute of New Jersey to bring “the highest level of care for cancer available, based on the rapid research discoveries that are happening day to day.” An extremely high percentage of adult patients at the institute participate in clinical trials—15 to 17 percent, as opposed to the national average of 3. That means, says Susan Goodin, deputy director for operations and assistant director for clinical science, that patients at the institute are more likely “to receive new drugs with the potential to be better than what’s currently available.”

They may also benefit from the institute’s new Precision Medicine Initiative (PMI), a personalized approach to treatment based on the growing understanding that cancer isn’t one disease but a collection of many diseases and sub-diseases. Patients enrolled in PMI—many of whom have rare cancers for which there are no standard treatments—have their tumors gene-sequenced to find the genetic abnormality that caused their particular cancer. “PMI allows us to enroll patients in trials for new therapies that target their specific mutation,” says Goodin.

PMI is only one aspect of the individualized approach that marks the Cancer Insti­tute’s standard of care. “You didn’t feel like a number,” says Glickman of his treatment. “They walked you through the process, emotionally and medically.”

Nine years ago, he founded Century for the Cure, which started with 10 riders and has now raised more than $1 million to fund research at the institute. Founding the charity was a necessary way to give back. “I needed to do something to thank the Cancer Institute of New Jersey for the phenomenal care,” he says, “and for giving me life.” •

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Seventy percent of the children and adolescents treated at the Cancer Institute of New Jersey are enrolled in a clinical trial.
Seventy percent of the children and adolescents treated at the Cancer Institute of New Jersey are enrolled in a clinical trial. Photography by Nick Romanenko

Hardly Kid’s Stuff
Pediatric cancer is relatively rare—and so are its cures. Thanks to the clinical trials conducted at the Rutgers Cancer Institute of New Jersey, lifesaving drugs and therapies are increasingly available.

At 15, you shouldn’t have to contemplate your own mortality, but a bone tumor changes things. In 1996, a diagnosis of bone cancer plunged Keith Pasichow into a world of blood draws, surgical interventions, chemotherapy, and clinical trials. If you’d asked him then, it’s unlikely that Pasichow would have called himself lucky. But luck was with him, in the form of a clinical trial at the Rutgers Cancer Institute of New Jersey, where he was given an investigational drug that very likely saved his life.

During surgery, doctors found that the drug had already destroyed 90 percent of his tumor cells. “For the first time,” he remembers, “we had the sense that things were going well.” That was 17 years ago, and today Pasichow is a pediatric oncologist, his career decision influenced in large part by the disease—and the clinical trial—that changed everything.

Seventy percent of the children and adolescents treated at the Cancer Institute are enrolled in a clinical trial, whether for an experimental drug or procedure or for a new method of analyzing tumors, treating pain, or following up after treatment. That’s in comparison to 3 percent of adult cancer patients nationwide offered the same opportunity. Because pediatric cancers are rare—13,000 diagnosed annually, compared to 1.5 million adult cancers—virtually all cancer trials for children are open to any patient, anywhere.

“We learned in the early ‘60s that since no one cancer center has enough pediatric patients for a trial of its own, the only way we could defeat childhood cancer was to work as a group,” says Richard Drachtman, the Cancer Institute’s interim chief of pediatric oncology. When Drachtman talks about group trials to patients and families, the benefits become clear: “I say, ‘There are more people than just me looking at you. A whole group of doctors and nurses are reviewing the data and using that information to guide the protocol, and that knowledge will come back to help you.’”

And it does. Virtually everything about the way pediatric cancer patients are treated today derives from clinical trials conducted over the last half century. In the 1960s, acute lymphocytic leukemia—the most common pediatric cancer—was uniformly incurable. Thanks to a series of clinical trials, nearly half of all patients treated for the disease now survive. And children who’ve been treated for Hodgkin’s disease are no longer submitted to extensive, potentially harmful, radiation after treatment, because data from clinical trials showed that protracted follow-up scanning was unnecessary. As Drachtman tells his patients, “The only reason I can sit in front of you and say I can make you better is all the kids before you who took part in trials.” •