March 24, 2017 | last updated March 26, 2017 2:55 pm
Greater Hartford Health

Cancer clinical trials could lead to better outcomes

Photo \\ Steve Laschever
Photo \\ Steve Laschever
Earlier this month, St. Francis Hospital infusion nurse Brooke Chaves placed an IV in Fred Fieldhouse's chest port to ready him for a dose of Kyprolis. Fieldhouse reads during the treatment and chats with the nursing staff.
HBJ Photo \\ Matt Pilon
Dr. Jonathan Sporn, hematology-oncology chief at St. Francis.
Photo \\ Contributed
John Hayes (far right) completes the Hartford Marathon with family less than one year after surgery for late-stage kidney cancer.

There aren't many experiences more terrifying than receiving a cancer diagnosis.

Sixty-year-old Simsbury resident John Hayes has a vivid memory of the day two years ago when he was diagnosed with late-stage kidney cancer, a disease that spread to several nodes in his neck and abdomen, forced him to undergo chemotherapy and eventually cost him his kidney.

"Sitting in that room waiting for that scan alone, it was the scariest and most lonely time in my life," Hayes recalls.

Stage 4 kidney cancer is a serious diagnosis that has a five-year survival rate of approximately 12 percent, according to the American Cancer Society.

As of his most recent scan last May, however, Hayes was cancer free, and he may have an experimental immunotherapy drug to thank.

Every two weeks since Jan. 2016, Hayes has traveled to Hartford Hospital for an infusion of the drug, Nivolumab (brand name Opdivo), which a recent study found had extended survival rates for certain kidney-cancer patients.

Such drug trials are becoming more available in Connecticut thanks to partnerships between area hospitals and major cancer-research institutions. St. Francis Hospital and Medical Center, for example, has teamed with Yale New Haven Health's Smilow Cancer Hospital, while Hartford Hospital recently cemented ties with New York's Memorial Sloan Kettering (MSK).

The partnerships, still in their infancies, could allow the Hartford hospitals to access a portfolio of earlier-stage drug trials, which have long been under the purview of major research institutions.

"We're getting better trials than we ever had before," said Dr. Peter Paul Yu, physician in chief at the Hartford HealthCare Cancer Care Institute. "These trials are more interesting and are much more likely to succeed."

Doctors at Hartford's two competing hospitals, each of which has long participated in cancer trials, want to offer the latest treatments without making patients drive or fly to other trial sites. Avoiding travel is better for patients with weak immune systems and limited financial resources.

Hospitals are also eager to play a more significant role in the evolution of cancer research and treatment and keep more patients in-house.

"I feel better about myself as a physician if … I'm involved in the development of these drugs," said Dr. Jonathan Sporn, chief of hematology-oncology at St. Francis.

Scientific advances have spurred prestigious cancer centers to look for hospital partners to participate in more cutting-edge trials.

Large institutions need access to more patients as oncology research becomes increasingly targeted, the result of advances in genomics, which tailors treatments to an individual's genetic makeup. The two hospitals also pay their cancer partners, though they don't disclose financial terms.

Docs work to overcome patient concerns

Enfield resident Frederick Fieldhouse, 61, visited the doctor last year after injuring himself at his landscaping materials company.

The visit led to a surprise diagnosis of multiple myeloma, a blood cancer.

"When you first find out you have cancer, you think you're dying right away," Fieldhouse said.

Fieldhouse said he was lucky that a doctor caught his cancer early. Those in the earlier stages have a five-year survival rate of about 50 percent. Fieldhouse's oncologist, Dr. Jaykumar Thumar, urged him to enroll in a clinical trial at St. Francis studying a drug called carfilzomib, or Kyprolis. The trial aims to compare Kyprolis' effects to a standard treatment to determine if the drug can extend remission duration and reduce side effects.

Most oncology trials ultimately fail because they can't enroll enough patients, but both St. Francis and Hartford Hospital hope that having trial sites locally will improve participation.

Fieldhouse placed his trust in Thumar.

"I said 'listen, I've got a beautiful girlfriend and two kids and three grandchildren,' " Fieldhouse recalled. "I told him to lead me on this journey and tell me what's best for me."

He enrolled in the trial and goes to St. Francis six times a month. Four months in, the scans were not detecting any cancer cells.

"I'm in complete remission and you can't ask for more," Fieldhouse said. "I'm 61 and I plan on being here until I'm at least 70."

Remission doesn't mean Fieldhouse is cured. It's a good sign, but his cancer can still recur. Thumar said it's difficult to know exactly what role the trial drug played in Fieldhouse's remission.

Some cancers, like testicular cancer, have a high cure rate using standard treatments. But for many cancers, including multiple myeloma, research trials remain the best option, Thumar said.

About 45 patients have enrolled in Smilow-related drug trials since St. Francis inked the partnership. The hospital is currently enrolling patients in 20 oncology trials; it hopes to have 50 trials available by year's end.

Meanwhile, Hartford Hospital has 100 ongoing trials, including 20 stemming from its MSK partnership. It hopes to get to 300 clinical trials within several years, Yu said. Hartford said it has more than 60 patients enrolled in MSK-related trials and a total of 360 in all oncology trials.

Giving back

After docs declared him cancer free, Hayes' thoughts turned to his favorite hobby: running.

He's run dozens of long-distance races and wanted to do last October's Hartford Marathon.

His doctors encouraged him to go for it.

Hayes wasn't able to train as much as he might have liked, but he finished the race in under six hours. His daughter Wendy and son Craig ran with him, as did his brother, who flew in from South Africa, where Hayes lived until 1998.

Hayes said he isn't sure Opdivo would have been available in his home country.

"I'm just very grateful we have these facilities and these drugs," he said.

Hayes was also fortunate that Bristol-Myers Squibb provided him with Opdivo free of charge. The drug can cost more than $100,000 a year. Hayes also has a good health plan through his employer, a Massachusetts insurance company.

His insurance began covering Opdivo treatments last year, following a key approval from the U.S. Food & Drug Administration.

"I kept thinking that there must be plenty of people that surely cannot afford this and are struggling to make ends meet," Hayes said.

In the wake of his cancer, Hayes' family has raised $5,000 and hopes to open a fund at Hartford Hospital that will help others facing the disease.

"After I was diagnosed, I've always had a positive outlook on this and always thought I could beat it," Hayes said. "And I'm going to keep thinking that."

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