Breakthroughs in Cancer Research and Treatment

https://www.nytimes.com/2023/07/01/opinion/letters/cancer-research-treatment.html

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To the Editor:

Kudos to Kate Pickert for her hopeful article, “Are We Learning to Outrun Cancer?” (Opinion guest essay, June 18). The answer is yes. I’m proof. Fourteen months ago, I was diagnosed with Stage IV metastatic colon cancer. Today, a year later, I am in full remission. Immunotherapy saved my life.

I’m 75, female and fortunate to live near the University of Michigan Rogel Cancer Center in Ann Arbor. In April 2022, an M.R.I. revealed a malignant “microsatellite unstable tumor” in my transverse colon. The tumor had spread to my lymph nodes, liver, peritoneum and lungs. I was told I probably had 2.5 years to live. I’d begin chemotherapy immediately.

Terrified, I switched oncologists. My new oncologist explained that my tumor qualified me for immunotherapy, not chemotherapy. Every three weeks, I was given IV infusions of Pembrolizumab, or “Pembro” (also known as Keytruda, the drug Ms. Pickert said reversed former President Jimmy Carter’s cancer). Eleven months later, after M.R.I.s and surgery, I was in full remission.

I never lost my hair, got nauseated, got burns on my skin, lost my sense of touch or poisoned other organs. My side effects were fatigue and slight brain fog.

Thank you for bringing these treatments to light, along with challenges in accessing them. This piece is essential to ignite new hope for survival.

Katherine ForsytheDexter, Mich.

To the Editor:

New treatments for cancer patients are giving the U.S. something we haven’t seen before: lung cancer survivors.

With many discoveries being made in lung cancer research, precision medicine has allowed us to drive treatment forward. A critical first step in precision medicine is biomarker testing, a method that identifies specific genetic “drivers” that cause cancer to grow and spread in different ways.

Take a teacher in Tennessee named Stephen Huff, who was diagnosed at 29 years old with stage IV lung cancer. Through biomarker testing, he was able to receive a targeted therapy for his specific mutation. Six years later, he’s continuing to live his life with his wife, child — and stage IV lung cancer.

A decade ago, treatment options were limited to surgery, chemotherapy and one targeted therapy, with a short-term life expectancy. Now, with the emergence of more than 50 therapeutic options, living longer and better after a lung cancer diagnosis is a reality for many patients.

We need to continue investing in research to revolutionize treatments to create a world where no one dies from cancer.

Upal Basu RoyBethesda, Md.The writer is the vice president of research at LUNGevity Foundation, a lung cancer research nonprofit.

To the Editor:

As the bereaved parent of a child lost to cancer, I read Kate Pickert’s essay with great interest on Father’s Day. Ms. Pickert’s excellent essay closes by saying “we can do better” in ensuring that all patients benefit from breakthrough treatments.

The article, however, does not discuss the pediatric patient population. Cancer is the leading cause of death by disease among kids. Those fortunate enough to survive face a lifetime of physical and emotional challenges from the toxic treatments they endured.

Unfortunately, our nation’s commitment to pediatric oncology research does not match this devastating reality. Children are not little adults, and the drivers of their malignancies are entirely different than those of adults, so effective therapy demands a different approach. If there is a patient population desperate for less toxic, more effective treatments, it is our kids.

Too often, children are left behind because of the rarity of pediatric cancer. This needs to change. The revolution in next-generation therapies should prioritize children. They deserve nothing less.

Gavin LindbergGermantown, Md.The writer is the president and co-founder of the EVAN Foundation, which supports research in neuroblastoma and pediatric cancer.

To the Editor:

While Kate Pickert points out many disparities in care and outcomes, she doesn’t mention a big factor tied to many revolutionary treatments: biomarkers.

Black women like me, for example, are more than 50 percent less likely to receive genetic and genomic tests to identify biomarkers for breast cancer that make us eligible for precision oncology clinical trials and lifesaving targeted drugs, such as antibody drug conjugates, which target specific tumor cells.

Precision oncology requires knowing the mutations driving a person’s breast cancer. Biomarkers are the key to unlocking cancer risks and treatment.

However, many nonwhite women, like me, aren’t being tested, so when a clinical trial is looking for women with a specific genetic mutation, we won’t know we are eligible because we don’t know that we have that mutation. When the latest lifesaving drug comes on the market, we won’t know if the drug is right for us because our biomarkers aren’t known.

As a unicorn — a Black woman with metastatic breast cancer, former health care executive, clinical trial participant and beneficiary of biomarker testing — I know we need to make biomarker testing more accessible to change the trajectory for all women of color.

Laura CrandonClarksville, Md.The writer is the founder and president of Touch4Life, a breast-health equity nonprofit.

To the Editor:

Kate Pickert’s essay highlights recent progress in drug development for metastatic cancer. But it doesn’t mention one of the most promising treatments for metastatic cancer: curative intent radiation therapy to all areas of known metastatic disease.

With the development of advanced radiation technologies capable of sparing normal tissues, many oncologists have started using involved site radiation for select patients with limited distant metastases. By safely administering radiation to all areas of known disease, usually in combination with systemic therapies, such as chemotherapy and hormonal therapy, previously incurable patients can now achieve deep or even complete remissions.

In my (Johnny’s) experience of treating 130 patients with limited metastatic disease from 2014 to 2021, 30 patients are not only alive, but also without evidence of disease. Radiation controlled the targeted tumors in more than 90 percent of patients with minimal toxicity.

Combining metastasis-directed radiation therapy with the diverse portfolio of promising cancer therapies highlighted in the essay may provide the optimal path toward achieving a revolution in cancer treatment instead of focusing on drug therapy alone.

Johnny KaoCaleb KaoJericho, N.Y.Johnny Kao is the chairman of radiation oncology and director of the Cancer Institute at Good Samaritan University Hospital. Caleb Kao helped analyze the data in this letter.