Advances in cancer treatment not only look at the effectiveness in destroying cancer cells but also how well patients tolerate those methods.
Dr. Vaishalee Kenkre, a hematologist specializing in lymphomas and faculty director of the UW Carbone Cancer Center Clinical Research Central Office, is overseeing a clinical trial testing a new initial treatment approach for follicular lymphoma to reduce side effects and improve patient comfort.
Kenkre has partnered with Dr. Andrew Evens, a hematologist at Rutgers Cancer Institute to launch the multi-site investigation as part of the Big Ten Cancer Research Consortium, a collaboration of 16 Big Ten research universities to share resources, knowledge, and infrastructure to advance new cancer discoveries and improve patient care.
“Big Ten CRC helps streamline things and make it smoother to communicate and operate,” Kenkre said.
Follicular lymphoma is a slow-growing cancer that affects a form of white blood cells called B-cells. While it is treatable and patients can live with managed disease for many years, it is not currently a curable form of cancer. As a result, if patients do not have bothersome symptoms and have a low amount of cancer, their care team will just monitor them until treatment becomes necessary.
“We don’t treat patients who have a low burden of disease and no symptoms, because if we can’t cure them and they have a good quality of life without their cancer growing aggressively, then they wouldn’t benefit from going through treatments yet and potentially may feel worse due to side effects,” she said.
The standard initial treatment for these patients, when treatment is required, is six rounds of chemotherapy along with immunotherapy, which helps the patient’s immune system recognize and attack cancer cells. This clinical trial tests the addition of a targeted therapy drug to the chemotherapy and immunotherapy, except only three rounds contain the chemotherapy portion. Kenkre said the targeted drug is currently used for follicular lymphoma patients who have had their cancer return, and it has been very effective and well tolerated by patients.
This approach of moving approved treatment for relapsed disease earlier in the lines of therapy is common in evaluating new methods of cancer treatment.
“The way these things often evolve is that the novel agents are studied in (patients with) relapsed disease, where there are fewer treatment options, and if the agents are working well, you can start moving them earlier into care so we can get things under better control earlier on in treatment,” Kenkre said.
Reducing the amount of chemotherapy needed for effective treatment also improves patient comfort. The research team is encouraged by the responses among study patients so far.
“We’re looking to see equivalent or better outcomes (to the current treatment) because if we can achieve that with less side effects of chemotherapy, that’s a win,” she said.
UW Carbone is an active teammate and leader in the Big Ten Cancer Research Consortium, including earning the group’s Institutional Leadership Award in 2021, 2023 and 2024. Dr. Kari Wisinski, a breast medical oncologist and Associate Director of Clinical Research at UW Carbone, is on the consortium’s steering committee.
Working together, the Big Ten cancer centers enroll more than 30,000 patients on cancer clinical trials. Because of the geographic coverage of this network, a greater number of patients have access to these trials than each institution working alone. For example, this follicular lymphoma treatment trial is ongoing at UW, Rutgers, Ohio State, Northwestern and University of Illinois Chicago.
“To be able to have enough patients to make the endpoints come together scientifically, it’s really useful to have all of these institutions involved in the consortium,” Kenkre said. “We definitely enrolled patients very quickly, and that exceeded my expectations. It’s also a nice example of us not necessarily being geographically near each other to reach more patients.”
Learn more about Carbone’s clinical trials and how to get involved