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UCLA, VA join forces to give veterans access to state-of-the-art cancer care

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Veterans are at increased risk for various types of cancer, but administrative and financial roadblocks often prevent them from access to clinical trials outside of the VA health care system.

A new 2-year pilot program aims to streamline this process for U.S. veterans in the Los Angeles area by allowing these patients to enroll in early-phase cancer treatment trials led by researchers at UCLA.

Fairooz Kabbinavar

HemOnc Today spoke with Fairooz Kabbinavar, MD, professor of hematology and oncology at UCLA and a co-leader of the joint program, about how it came about, its mission and how it will evolve over time.

Question: How did the UCLA and VA cancer care for veterans program come about?

Answer: Dennis J. Slamon, MD, PhD, chief of the division of hematology–oncology at UCLA, Matthew Rettig, MD, medical director of the prostate cancer program at the Institute of Urologic Oncology at UCLA, and I sat down and realized that — although we had a very active and robust cancer clinical trials program at the main UCLA campus — we did not have something similar at VA West Los Angeles Medical Center. We wanted to set up something similar to this at the VA hospital. As we looked at the division of hematology/oncology at the VA hospital, there were no active clinical trials being conducted. This is how this program started. I was then asked to head the program, so I went to the VA hospital, applied for privileges and then began building the clinical trials program.

Q: What was the impetus for this program?

A: The veterans receive their cancer care at VA West Los Angeles Medical Center. However, without an active clinical trials program, veterans did not have access to new and cutting-edge treatments that had not yet been approved by the FDA. It is the unfortunate reality for patients with advanced cancer that they are only able to receive new, novel cutting-edge treatments via a clinical trial. This was an unmet need for cancer patients at VA West Los Angeles Medical Center and was the driving force for us to bring clinical trials to the VA cancer patient population.

Q: What cancer types will be the focus?

A: We see a very fair amount of lung cancer, head and neck cancer, prostate cancer and colon cancer at VA West Los Angeles Medical Center. It is the hope that many of the trials will target these common malignancies. We do not currently see many breast cancer patients, because there are not very many female veterans at our facility at this time.

Q: What types of trials have been initiated so far?

A: Early on, the process was slow because I was trying to gain my privileges as well as establish a team. We have one trial in prostate cancer and one in colorectal cancer that are currently enrolling. We have another three trials in lung cancer that have been opened for enrollment and a fourth lung cancer trial that we have submitted to the institutional review board. We have another trial soon to be opened in head and neck cancer. This new program has developed traction and we are very excited about it. It has been about one and a half years now that the program has been off the ground and we hope it becomes as much of a success as our program at the main campus. It is a win-win situation for our veterans with incurable cancers, as it provides them a way to access new cutting-edge molecules.

Q: What type of challenges and roadblocks have you encountered so far?

A: The challenges that we have faced are much like any programs just starting out. Working in the veterans system, there are more rules and regulations that cause things to move a little more slowly than usual. Other challenges have come, but they have all been resolved now.

Q: How do you see the program evolving?

A: We will continue to bring new trials and new treatments to our veterans with cancer through our clinical trials program. Once we show that we can deliver quality research, others will follow. Our goal is to initiate trials that cover some of the most common cancer types among veterans seeking medical attention at a VA facility. Once we are able to show that the clinical trials program has been met with some degree of success and we can deliver high-quality cancer care to our veterans, I think other VA facilities will follow suit. One issue is that most of our clinical trials come through the pharmaceutical industry. Once we are able to show other VA facilities and the pharmaceutical industry that we can deliver high-quality health care and research then the industry will begin to bring trials to the VA facilities. My sense is that it is going to take some convincing of the industry, but it will ultimately be a win-win situation for our VA patients. Progress in oncology can only be made through research.

Q: What type of an impact might this program have on overall cancer care for veterans?

A: All U.S. veterans receive high-quality health care through VA facilities, but what was lacking was access to newer cutting-edge clinical research and novel drugs. Once we get this program going and can show other VA facilities that it works, then other VA facilities around the country hopefully will start with clinical trial programs of their own and hopefully all VA cancer patients will have access to new treatment options via cancer clinical trials.

Q: Do you have any final thoughts?

A: VA cancer patients should not only discuss the FDA-approved treatments with their oncologist, they should always inquire how to take part in clinical trials. Patients and their relatives have to be proactive and ask their treating physician about the availability of clinical trials.

For more information:

Fairooz Kabbinavar, MD, can be reached at the UCLA Hospital, 924 Westwood Blvd. #1050, Los Angeles, CA 90024; email:fkabbina@mednet.ucla.edu.

Disclosure: Kabbinavar reports no relevant financial disclosures.