Q&A with Dr. Eric Nadler, Medical Oncologist, Texas Oncology–Baylor Charles A. Sammons Cancer Center
How is the trend to focus more on a tumor’s composition rather than its location or cancer type changing how we treat cancer?
Molecular biology and immunotherapy are two of the biggest advances in oncology during the past decade. They have changed cancer treatment dramatically by providing more targeted options based on an individual’s cancer. Once we understand the molecular composition of a person’s cancer, we can use a therapy that specifically targets that pathway – leading to less toxic treatment and better outcomes. We’re also beginning to understand which patients are best served by immunotherapy and which patients are not. Immunotherapy uses the body’s immune system to fight cancer. The key is knowing which patients can benefit from it.
How do you leverage the molecular makeup of the cancer to identify treatment plans?
We’re increasingly able to personalize treatment plans irrespective of the location of the cancer. It’s very important that patients and their oncologists discuss personalizing their care at the time of diagnosis. If patients don’t ask for it and doctors don’t press for obtaining this information, we may miss testing opportunities beneficial to the treatment plan.
Our Texas Oncology research team was integral in recent research studies on treating defects rather than just cancer subtypes. It’s a complete paradigm shift on how we look at cancer."
Eric Nadler, M.D., MPP, Medical Oncologist
Texas Oncology–Baylor Charles A. Sammons Cancer Center
How does Texas Oncology use testing to determine certain tumor markers?
Texas Oncology is uniquely positioned for patient testing. We work closely with testing companies to determine the types of molecular studies needed to best inform our treatment decisions. In addition, our embedded electronic infrastructure requires evidence-based decisions through data points and requires physicians to input molecular tests into each patient’s chart. This is evolving rapidly. Five years ago, we routinely tested for potentially five determinants in a given cancer, and now we test for more than 50 items. In Texas Oncology, our physicians have achieved incredibly high levels of adoption of this technology. I would expect that knowledge base and understanding of cancers to grow exponentially each year.
How is Texas Oncology propelling the trend forward of utilizing drugs that are not specific to one cancer type (such as breast and lung), and how will it improve treatment?
Our Texas Oncology research team has been integral in recent research studies on treating molecular targets rather than just simply traditional cancer subtypes. These include DNA repair enzyme defects and immunotherapy. We expect more clinical protocols on genetic aberration over the next five years. It’s a complete paradigm shift on how we evaluate and assess a given cancer. There are a number of niche (or rare) cancers that do not have enough patients within the United States to conduct large clinical trials or initiate heavy investment by pharmaceutical companies. This type of genetic or molecular testing will allow us to enroll patients with more unique diseases into new therapeutics. That’s going to be an increasing trend, and we’re excited about it.