No one doctor, institution, or country can cure cancer on their own. The war on cancer must be fought internationally with teams collaborating across political boundaries. That was the key message of the 2021 Forbes China Healthcare Summit, which brought together leaders in cancer research, philanthropy, and international relations.
“Since 1884, MSK’s mission has been to cure cancer through improved patient care, research, and education, not only in New York or in the United States, but around the world, ” said Lisa DeAngelis, Physician-in-Chief and Chief Medical Officer of MSK as she kicked off the online summit on August 28. “We must bring the world together to accelerate clinical trials.”
One of the participants was Kevin Rudd, the 26th Prime Minister of Australia and CEO of the Asia Society, which fosters relationships between Asia and the world through education. Mr. Rudd said he frequently hears from people who want to help fix US-China relations, achieve world peace, or undo climate change. Three years ago, he was visited by a doctor from MSK.
“Back in 2018, Bob Li walked into my office at the Asia Society and said, ‘We’d like to find a cure for cancer,’” Mr. Rudd recalled. “What I really was impressed by was the passion in Bob’s commitment and the fact that it was deeply practical as well.”
Dr. Li is MSK’s Physician Ambassador to China and Asia-Pacific who highlighted MSK’s collaboration with Chinese Thoracic Oncology Group (CTONG), a program of clinical trials that are open to patients from both the United States and China. The initiative is focusing initially on clinical trials of precision cancer therapies for lung cancer, the number one cause of cancer deaths in both nations.
“This is not something that a single institution can achieve,” said Dr. Li. “This is something that requires cross stakeholder collaboration between academia, industry, government regulatory agency leaders, policy leaders, philanthropy, and patient support representatives — all working together.”
Another step toward international collaboration is Project Orbis, an initiative of the US Food and Drug Administration’s (FDA) Oncology Center of Excellence (OCE). Project Orbis provides a process to allow for submission and review of cancer treatments simultaneously across several countries. In September of 2019, the first Project Orbis action took place when two drugs were approved for the treatment of people with endometrial cancer in the US, Canada, and Australia all at the same time. In May 2021, sotorasib (LumakrasTM) received accelerated approval as part of Project Orbis after clinical trials led by Dr. Li and MSK.
“We really foster and are interested in seeing international trials rather than just country-specific trials,” said Richard Pazdur, director of the FDA’s OCE. “We really believe that the internationalization and the collaboration of all clinical investigators and all regulatory bodies working together will promote timely availability of breakthrough therapies throughout the world.”
The Need for Diversity
Today, only 3 to 5% of patients enroll in clinical trials in the US. And though the figure is much higher at MSK — about 25% — there is still a lot of work to be done.
“This lack of participation creates a lack of diversity in studies,” said Sir Murray Brennan, who moderated a panel. “One way to bridge that gap — so we can learn more from clinical trials — is through international collaboration.”
Dr. Brennan is Senior Vice President of International Programs and Benno C. Schmidt Chair in Clinical Oncology at MSK.
Making It Easier to Participate
Whether a person lives in the US or another country, Dr. Li said, it can be a burden to participate in a clinical trial. Beyond taking time off work and the cost of travel and hotel accommodations, a patient also needs to provide consent, wait for nurses and doctors to see them, undergo numerous tests and then hope that they fit the criteria to be on the trial. Once they are part of a clinical trial, they need to visit the hospital and be monitored frequently.
“It could be untenable for many, many people, especially in underprivileged communities,” Dr. Li said. But lessons learned during the pandemic can be applied to make clinical trial participation easier.
“COVID-19 has taught us the use of technology can help solve many of those barriers and can […] bring the trial to the patient rather than the other way around,” he said. “In fact, in the [sotorasib] trial, we were forced by the pandemic to do a lot of this — to use remote telemedicine, remote telemonitoring, to continue to push the trial forward.”
A Good Investment
Ultimately, new technology requires an investment and clinical trials themselves are expensive to run. Kenneth Manotti, Senior Vice President and Chief Development Officer at MSK, led a panel to discuss the importance of philanthropy in cancer research.
“I’ve had the privilege of being at MSK for the past three years, and I’ve seen firsthand the profound impact that philanthropic and venture support have had on our ability to fulfill our mission,” he said.
Dr. DeAngelis emphasized that clinical trials represent the critical step of translating scientific discovery to saving lives.
“It is my hope that this summit serves as a springboard for new collaborations, which have never been more important,” she said to the participants. “As we navigate through the COVID pandemic, MSK is committed to this international mission, and we appreciate your collaboration on this journey.”