August 1, 2014

Lou Fehrenbacher, MD, discusses grant to cancer program

This month, the National Cancer Institute awarded the Kaiser Permanente Oncology Clinical Trials program with a $7.3 million grant over the next five years. The grant will provide many of Kaiser Permanente’s oncology research centers with vital funding to continue conducting clinical trials and research studies designed to improve cancer treatments. Lou Fehrenbacher, MD, is the medical director of Kaiser Permanente Oncology Clinical Trials and an oncologist with the Kaiser Permanente Vallejo Medical Center. We checked in with him to find out more about oncology clinical trials at Kaiser Permanente and what this grant means for the future of oncology research.

Tell us a bit about Kaiser Permanente Oncology Clinical Trials.

At Kaiser Permanente, we have a commitment to offer “state of the art” treatment to our members. As part of this commitment, we created the Kaiser Permanente Oncology Clinical Trials program, which consists of a team of oncologists, nurses and research specialists who review and select clinical trials for study. Some of these trials may investigate new cancer drugs, while others compare standard treatments against investigational treatments. Our oncology clinical trials program makes it possible for members to participate in promising new cancer treatments even before they are FDA approved and available commercially to the general medical community.

All of our current best standard cancer therapies were once experimental therapies being evaluated in a clinical trial. Only after clinical trials show one treatment to be superior over another can a therapy become a new standard of care. All cancer drugs must first pass through clinical trial evaluation.

What differentiates Kaiser Permanente clinical trials from other programs?

Kaiser Permanente can make enormous contributions to cancer research because we are a population-based organization and the patients we study are as diverse — socioeconomically and ethnically — as our member population. We enroll a high percentage of minorities compared to other research sites. For example, 35 percent of our member base is non-Caucasian and we enroll about 30 percent of non-Caucasians into our program. As a result, the cancer research we produce tends to be representative of the majority of our member population and society. In addition, our patients have a unique advantage in that our integrated electronic medical record maps a patient’s treatment history with relevant, ongoing internal and external trials that may offer better results. One example of this is our KPStudySearch website which helps inform patients, caregivers and investigators about ongoing clinical research opportunities being conducted through Kaiser Permanente.

Who can participate in a Kaiser Permanente oncology clinical trial?

Older asian man with arm over adult son talking on a tennis court

Clinical trials are open to Kaiser Permanente members in most of our regions, including Northern and Southern California, the Pacific Northwest, Colorado and Hawaii. Patients may qualify for a trial if they have a cancer diagnosis and are interested in access to new, cutting-edge treatments. At any given time, there are at least 50 cancer trials underway that are open to eligible Kaiser Permanente patients. In fact, we have become one of the national leaders in the National Cancer Institute’s clinical trials program, enrolling between 400 and 500 patients into these trials every year.

Could you tell us about the National Care Institute’s Community Oncology Research Program?

The overall goal of the NCI NCORP is to bring access to cancer clinical trials, as well as cancer care delivery research, to individuals in their own communities to help improve patient outcomes and reduce cancer disparities among various populations. The NCI created this new NCORP program for implementation in 2014, through a request of applications in late 2013. This year, Kaiser Permanente Oncology Clinical Trials was awarded a $7.3 million, five-year grant that will provide vital funding to continue conducting clinical trials and research studies designed to improve cancer treatments.

How will the Kaiser Permanente Clinical Trials program use these funds?

The grant will fund three areas of work.

  • Provide cutting edge clinical trials to our patients in the Kaiser Permanente Northern California, Southern California, Northwest, Colorado and Hawaii regions.
  • Participate in cancer control and prevention research. These are studies that research how diet, exercise, medication or other lifestyle changes can prevent cancer or contribute to managing cancer symptoms, an area of study that is becoming increasingly important.
  • Evaluate cancer care delivery research. This is a new area, funded by the National Cancer Institute, researching the best ways of delivering cancer care throughout the country.

What cancer care delivery research is planned at Kaiser Permanente?

Kaiser Permanente’s cancer care delivery research will be looking at the issues that generally aren’t examined when conducting a standard cancer drug-to-drug comparison. This work will include evaluations of delivery systems, cost comparisons, cost analysis, efficiency and outcome disparities, and their effects on cancer patient care. Kaiser Permanente will play a critical role in the design and implementation of these studies as we have many researchers in Northern California and other regions who are experts in cancer care delivery and who study diverse patient populations. These Kaiser Permanente scientists are actively working with our extensive electronic medical records systems and are well-positioned to study cancer care delivery and design the studies that the NCI will conduct. Those research efforts will eventually define the methods of our own cancer care.

What are some examples of clinical trials that have come out of your organization?

One of our most successful clinical trials was the evaluation of a drug called trastuzumab (Herceptin). The drug was given to women who had a specific type of breast cancer, and the trial showed that this drug was very successful in preventing the cancer from returning. In a more up-to-date example, we are working with a pharmaceutical company to treat lung cancer patients with a brand new therapy that helps to trigger the immune system to attack the cancer itself. We’ve enrolled 15 patients into this study in the last month alone.

Finally, to give an example of a care delivery study that we are currently working on, we are evaluating whether frequent text messages that are motivational and serve as medication reminders help women with breast cancer stay adherent to their daily oral medicine. These are just a few of the examples of the exciting work that is coming out of the Kaiser Permanente Oncology Clinical Trials Program.