Basket trials: Better response rate than chemotherapy?
New hope for patients with advanced cancer
For patients with advanced cancer who are running out of treatment options, some oncology research centers are offering a new hope, in the form of basket trials.
Basket trials are targeted studies that test the effect of one drug on single mutations in various tumour types. In other words: doctors match drugs to a tumour's weak spot. Unlike traditional clinical trials, which test cancer treatments according to the type of disease - like breast or lung cancer - basket trials use molecular technology to offer new therapies to patients and can increase the number of patients who can receive certain drugs.
Dr. Lee Schwartzberg, Executive Director of West Cancer Center (WCC) — a leading cancer research and treatment practice — and oncology scientific lead at George Clinical, says: “The field of precision oncology has the potential to benefit many more cancer patients than traditional clinical trials, and basket trials are generating firm evidence supporting the use of targeted drugs for tumours”.
To date, the US Food and Drug Administration (FDA) has approved dozens of targeted therapies for various cancers, most of which work by blocking mutated proteins that progress cancer. In 2017, the FDA endorsed - for the first time - an immunotherapy drug for treatment based on a tumour’s molecular markers, rather than its location in the body.
But, some oncology researchers are cautious in hailing basket trials as the next frontier in cancer treatment. The new drugs being tested in basket trials may not have a better overall response rate than chemotherapy, and the trials themselves can vary significantly in design. However, basket trials are typically more complex than equivalent phase II clinical trials of new cancer drugs.
"The simplest basket trial, where a single drug targets a single mutation in numerous tumour sites, is still quite complex," says Dr. Schwartzberg. "These trials are different to traditional studies of single drugs in single diseases. There is still a lot of work to be done in precision medicine, but it is transforming our knowledge of cancer genomics and changing the way we treat patients".