1
|
Emens LA, Romero PJ, Anderson AC, Bruno TC, Capitini CM, Collyar D, Gulley JL, Hwu P, Posey AD, Silk AW, Wargo JA. Challenges and opportunities in cancer immunotherapy: a Society for Immunotherapy of Cancer (SITC) strategic vision. J Immunother Cancer 2024; 12:e009063. [PMID: 38901879 PMCID: PMC11191773 DOI: 10.1136/jitc-2024-009063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 06/22/2024] Open
Abstract
Cancer immunotherapy has flourished over the last 10-15 years, transforming the practice of oncology and providing long-term clinical benefit to some patients. During this time, three distinct classes of immune checkpoint inhibitors, chimeric antigen receptor-T cell therapies specific for two targets, and two distinct classes of bispecific T cell engagers, a vaccine, and an oncolytic virus have joined cytokines as a standard of cancer care. At the same time, scientific progress has delivered vast amounts of new knowledge. For example, advances in technologies such as single-cell sequencing and spatial transcriptomics have provided deep insights into the immunobiology of the tumor microenvironment. With this rapid clinical and scientific progress, the field of cancer immunotherapy is currently at a critical inflection point, with potential for exponential growth over the next decade. Recognizing this, the Society for Immunotherapy of Cancer convened a diverse group of experts in cancer immunotherapy representing academia, the pharmaceutical and biotechnology industries, patient advocacy, and the regulatory community to identify current opportunities and challenges with the goal of prioritizing areas with the highest potential for clinical impact. The consensus group identified seven high-priority areas of current opportunity for the field: mechanisms of antitumor activity and toxicity; mechanisms of drug resistance; biomarkers and biospecimens; unique aspects of novel therapeutics; host and environmental interactions; premalignant immunity, immune interception, and immunoprevention; and clinical trial design, endpoints, and conduct. Additionally, potential roadblocks to progress were discussed, and several topics were identified as cross-cutting tools for optimization, each with potential to impact multiple scientific priority areas. These cross-cutting tools include preclinical models, data curation and sharing, biopsies and biospecimens, diversification of funding sources, definitions and standards, and patient engagement. Finally, three key guiding principles were identified that will both optimize and maximize progress in the field. These include engaging the patient community; cultivating diversity, equity, inclusion, and accessibility; and leveraging the power of artificial intelligence to accelerate progress. Here, we present the outcomes of these discussions as a strategic vision to galvanize the field for the next decade of exponential progress in cancer immunotherapy.
Collapse
Affiliation(s)
| | | | - Ana Carrizosa Anderson
- The Gene Lay Institute of Immunology and Inflammation, Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Tullia C Bruno
- Department of Immunology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christian M Capitini
- Department of Pediatrics and Carbone Cancer Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Deborah Collyar
- Patient Advocates in Research (PAIR), Danville, California, USA
| | - James L Gulley
- Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Avery D Posey
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Ann W Silk
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
2
|
Shakhnenko I, Husson O, Chuter D, van der Graaf W. Elements of successful patient involvement in clinical cancer trials: a review of the literature. ESMO Open 2024; 9:102947. [PMID: 38492274 PMCID: PMC10959641 DOI: 10.1016/j.esmoop.2024.102947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/18/2024] Open
Abstract
Patient involvement in clinical cancer research has gained much ground in the past few years and studies demonstrated positive outcomes of such involvement. Yet, they also indicated a lack of evidence around best methods and practices to achieve successful patient involvement. The aim of this literature review was to provide a synthesis of elements contributing to successful and meaningful ways of involving patients in oncology trials across different stages of research. This synthesis can offer practical support to researchers in their patient involvement journey. A PubMed literature search for original articles published between 2012 and early 2023 was carried out. In total, 3132 articles were identified, among which 152 were fully assessed for eligibility. Thirty-three articles met the predefined inclusion criteria and were subjected to a quality checklist. Patient involvement occurred most often in the development stage of cancer trials (85%) and was continuous and integrated throughout the entire lifecycle of research (67%). In total, 58 elements of successful patient involvement were identified, such as clearly defined roles and responsibilities of patient partners, input of multiple patients to ensure diversity, and regular touchpoints in the project. All these elements can be applied in future studies from the planning stage to the dissemination of study results. This review provides a set of practical recommendations that can be used by the cancer research community when planning to involve or already involving patients in their clinical trial activities.
Collapse
Affiliation(s)
- I Shakhnenko
- European Organisation for Research and Treatment of Cancer (EORTC Headquarters), Brussels, Belgium
| | - O Husson
- Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam; Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - D Chuter
- EORTC, Patient Panel, Brussels, Belgium; Digestive Cancers Europe (DiCE), UK
| | - W van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam; Department of Medical Oncology, Erasmus Medical Centre Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| |
Collapse
|
3
|
Frank C, Gyawali B, Booth CM. Common sense cancer care for older adults: Outcomes that matter. J Am Geriatr Soc 2023; 71:3977-3980. [PMID: 37539843 DOI: 10.1111/jgs.18529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/08/2023] [Indexed: 08/05/2023]
Affiliation(s)
| | - Bishal Gyawali
- Department of Oncology, Queen's University, Kingston, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Canada
| | - Christopher M Booth
- Department of Medicine, Queen's University, Kingston, Canada
- Department of Oncology, Queen's University, Kingston, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Canada
| |
Collapse
|
4
|
Cobb CBC, Heath CR, Byrd AS, McKinley-Grant LJ, Callender V, Adamson AS, Brown S, Desai SR, Glass DA, Jaleel T, Okoye GA, Taylor SC, Harvey VM. The Skin of Color Society's Meeting the Challenge Summit, 2022: Diversity in Dermatology Clinical Trials Proceedings. JAMA Dermatol 2023; 159:757-762. [PMID: 37223905 DOI: 10.1001/jamadermatol.2023.1285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Importance Clinical trials remain the cornerstone for determining the safety and efficacy of an intervention. A diverse participant pool in dermatology clinical trials is critical to ensure that results are generalizable among the patient population who will ultimately depend on the efficacy of the intervention. The Skin of Color Society hosted the inaugural Meeting the Challenge Summit: Diversity in Dermatology Clinical Trials in Washington, DC, from June 10 to 11, 2022. The summit was an interactive and collaborative effort to advance discussions regarding the need for broader inclusion of racial and ethnic minority patients in dermatology clinical trials. Observations The summit focused on 3 principal areas: (1) understanding the current clinical trials landscape; (2) breaking down patient, clinician, industry, and regulatory barriers; and (3) effecting change through a diversity-focused strategy. The program hosted thought-provoking panel talks and discussions with various stakeholder groups, including a keynote presentation from the family of Henrietta Lacks. Conclusions and Relevance Panel discussions and insightful presentations from physicians, industry leaders, community trailblazers, and patients fostered new collaborations. The summit provided recommendations and suggested strategies for future initiatives designed to increase the representation of minority individuals in dermatology clinical trials.
Collapse
Affiliation(s)
- Caryn B C Cobb
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Candrice R Heath
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Angel S Byrd
- Department of Dermatology, Howard University College of Medicine, Washington, DC
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lynn J McKinley-Grant
- Department of Dermatology, Howard University College of Medicine, Washington, DC
- Department of Dermatology, Duke University School of Medicine, Durham, North Carolina
| | - Valerie Callender
- Department of Dermatology, Howard University College of Medicine, Washington, DC
- Callender Dermatology and Cosmetic Center, Washington, DC
| | - Adewole S Adamson
- Division of Dermatology and Dermatologic Surgery, Dell Medical School at The University of Texas at Austin
| | | | - Seemal R Desai
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas
- Innovative Dermatology, Dallas, Texas
| | - Donald A Glass
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas
| | - Tarannum Jaleel
- Department of Dermatology, Duke University School of Medicine, Durham, North Carolina
| | - Ginette A Okoye
- Department of Dermatology, Howard University College of Medicine, Washington, DC
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Valerie M Harvey
- Hampton Roads Center for Dermatology, Newport News, Virginia
- Skin of Color Research Institute, Hampton University, Hampton, Virginia
| |
Collapse
|
5
|
Operationalizing Stakeholder Engagement Through the Stakeholder-Centric Engagement Charter (SCEC). J Gen Intern Med 2022; 37:105-108. [PMID: 35349021 PMCID: PMC8994015 DOI: 10.1007/s11606-021-07029-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
Abstract
There is a need for clear strategies and procedures to operationalize stakeholder engagement in research studies. Clear guidelines that promote shared leadership among study investigators and research stakeholders are important for inclusive and sustainable partnerships. Such guidelines may take the form of a governance charter and can be a means for encouraging the participation and inclusion of stakeholders who may have little to no experience with research or are otherwise underrepresented in research. This perspective article presents the Stakeholder-Centric Engagement Charter (SCEC), one effort to operationalize a stakeholder engagement approach between researchers and an advisory committee as guided by the Patient-Centered Outcomes Research Institute's (PCORI) Research Engagement Principles (i.e., reciprocal relationships, partnerships, co-learning, transparency-honesty-trust). Building on the SCEC can help future investigators develop a study-specific, dynamic, governance document outlining advisory committee and research team preferences in areas such as role expectations, study governance, and decision-making procedures.
Collapse
|