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Oncology... Oncology... Oncology... Oncology... Oncology... Oncology...

New Weapons in the Battle Against Blood Cancers

For more than 30 years, oncologists have used immunotherapy to chimeric antigen receptors, or CARs, which enable T cells to recognize
treat cancer, harnessing the strength of the patient’s own immune sys- and attach to a certain protein in tumor cells and kill them.
tem to fight the disease. For many, it has been a welcome alternative We see 70-80 new multiple myeloma cases each year and more than 300
or supplement to more traditional chemotherapy, radiation, and surgi- with relapse disease so, while not every patient will be a CAR-T candidate,
cal options. we’re hoping many more will be as the trial progresses. We’re using drugs
The disease I specialize in, multiple myeloma, has no cure, but under research that are unavailable anywhere else in Florida for myeloma
patients can maintain quality of life with treatment combinations. and expect to expand to include leukemia and lymphoma patients in the
These individuals have cancer cells form in plasma cells within bone coming year.
marrow, crowding out healthy (red and white) blood cells and damag- All this work is being done as we establish a myeloma-specific institute
ing bones, the immune system, and kidneys. We use immunotherapy at Moffitt/Memorial that will be the only one of its type in Broward and
in combination with chemotherapy to treat cancerous plasma cells, Palm Beach counties. Bringing specialists together and providing South
transitioning to different drugs when the cancer mutates and becomes Floridians access to clinical trials is part of what we’re planning, but it’s
resistant to the previously prescribed treatment. Our goal is to get BY CLAUDIA PABA also important to address the whole person and not just the disease. That’s
patients to a stem cell transplant or, if they aren’t an appropriate can- PRADA, MD why we’re already collaborating with the Leukemia and Lymphoma
didate, to utilize a combination of drugs to kill myeloma cells. We Society of Broward County and have established a support group for
then continue maintenance therapy to keep cancer cells dormant and myeloma patients and their caregivers. The group will address issues relat-
preserve their existing lifestyle. ed to a cancer diagnosis and provide opportunities for attendees to discuss concerns,
It’s critical that we never stop studying the biology of the diseases we see, since each anxieties, feelings related to their illness, treatment, and connected issues. Meetings,
patient is different and there is no one-size-fits-all treatment. What approaches have even the virtual ones we’re having during COVID-19, are designed to offer mutual
been used previously, their toxicity, and the patient’s comorbidities (diabetes, heart support and information to members by connecting them to others whose situations
issues, etc.) all factor into what may or may not be the appropriate next step. With are similar to their own.
younger, newly diagnosed patients, a more aggressive approach to get to transplanta- My own journey has taken me from my home country of Colombia to an internal
tion may be pursued. In older patients, the goal is usually to get to some level of medicine residency in Philadelphia, hematology/oncology fellowship in Memphis,
remission, even if that isn’t a permanent solution. and an advanced fellowship in hematologic malignancies at Dana Farber Cancer
Some myeloma patients, however, don’t respond to any of the available chemother- Institute in Boston. I was at Dana Farber for seven years before relocating to South
apy drugs or may have a cancer relapse after their transplant. That’s why there is Florida in 2017. I joined the Moffitt team at Memorial Hospital West in July and am
excitement within the cancer community about clinical trials we’re participating in at anxious to further the research and treatment of multiple myeloma at one of the
the nation’s leading cancer centers. CAR-T cellular therapy is one of the ways we can get
Moffitt Malignant Hematology and Cellular Therapy Program at Memorial Hospital there together.
West that have increased what we’re able to accomplish through immunotherapy.
The new approach is called CAR-T cell therapy and it’s administered like a blood Dr. Claudia Paba Prada is an oncologist/hematologist at the Moffitt Malignant
transfusion after the patient’s own T cells are reprogrammed to attack the cancer cells. Hematology and Cellular Therapy program within the Memorial Healthcare System. Her
This is done by genetically altering T cells so they produce synthetic molecules called primary clinical and research focus is multiple myeloma.

Biosimilars: Moving Forward with New Cancer Treatment Options

Every year, more than therapy, immunotherapy, opment to help produce innovative new similars are subject to the same official
30,000 people in South and hormonotherapy – drugs. scrutiny as other medications, and since
Florida receive a dreaded has increased the overall There was a time when chemotherapy the first biosimilar was introduced in the
cancer diagnosis. It’s a star- cost of health care. At a agents were the front line of cancer ther- American health care system in 2015,
tling number and often caus- time when increased apy. The high cost eventually led to the there is no evidence that any have been
es families to worry about patient access to afford- Hatch-Waxman Amendment in 1984, removed from the market due to con-
their loved ones, the cost of able health care is so which encouraged the production of cerns over effectiveness or safety.
treatments, and the disrup- essential, it’s vitally im - more affordable generics. More recent At the beginning of 2020, before words
tion to their lives and liveli- por tant that the American legislation, the Biologic Price Com - like “coronavirus” or “pandemic” were
hoods. Thankfully, break- health care system make petition and Innovation Act of 2009, part of everyday conversation, the feder-
throughs in oncology re - greater use of what are provided a way to license biosimilar al government had approved 26 biosimi-
search and treatments con- known as “biosimilar” agents, which are not chemically identi- lars, with more to come. If anything, the
tinued to advance at a BY LUIS E. RAEZ, MD, medications, which have cal but are highly similar to an approved ongoing crisis has made affordable
remarkable pace, benefiting FACP been in limited use since biologic agent. health care even more important.
patients and the health care they were introduced to There are many challenges in this As health care professionals, we have a
professionals who work tirelessly to care the U.S. market five years ago. wider use of biosimilars, beginning with responsibility to stay up to date on the
for them. Unlike generics, which are created the fact that physicians and other health latest developments in our fields. When
But innovative treatments and new through a chemical synthesis process, providers are used to dealing with the learning about new treatment options
therapy options are only effective if peo- biosimilars come from living systems. more traditional approaches and don’t like biosimilars, it’s important that we
ple know about them – particularly the But like generics, biosimilars can be pro- fully understand what biosimilars are. review the research and assess the bene-
physicians striving to develop treatment duced more affordably than conventional This creates mistrust and greater need fits for our patients. If the treatment can
plan for their cancer patients. As presi- treatment drugs. As their name suggests, for education among providers and end up reducing costs and increasing
dent of the Florida Society of Clinical these innovated treatments produce sim- patients. Another obstacle is the lack of access for patients – especially those
Oncology (FLASCO) and a practicing ilar responses among the most sensitive inclusion in insurance formulary lists, fighting cancer – then maybe we can
physician, I recognize the tremendous patient population, and through a which determine the treatments that are start to minimize the prevalence and
benefit, for those of us who work in the process of extrapolation they can be covered for patients. The reality is that impact of devastating diseases on our
oncology industry and for our patients, licensed for certain treatments that previ- biosimilars are developed through a rig- communities.
of communicating with one another ously required traditional therapies – orous process of scientific analysis and
about these new treatment options. This without the need for costly and time- clinical studies to ensure their safety and
is particularly true if these options can consuming repeated clinical trials. This effectiveness. Dr. Luis E. Raez is the President of the
improve patient care, minimize the helps reduce development costs, which In 2019, the FDA finalized guidelines Florida Society of Clinical Oncology
impact on patients, or lower costs. in turn ensures that biosimilars can be for manufacturers to follow in seeking (FLASCO) and serves as the Chief
As one example, there is no doubt that marketed at the lowest viable price and approval of biosimilar interchangeability, Scientific Officer and Medical Director for
the high cost associated with biologic frees up resources to be allocated to so the innovative treatments can be used Memorial Cancer Institute/Memorial
cancer therapies – things like targeted other areas, such as research and devel- for a broader range of patients. Bio - Health Care System.

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16 October 2020 southfloridahospitalnews.com South Florida Hospital News