Minneapolis VA boosts access to federal cancer trial

Researchers hope a new partnership with the Minneapolis VA Medical Center and other veterans' hospitals will boost growth in cancer studies and the development of drugs and personalized therapies.

Political, financial and other obstacles have limited VA hospitals' access to clinical trials offered by the National Cancer Institute, but a new NAVIGATE program is designed to address those barriers by increasing the screening of veterans with cancer for research, and eliminating criteria that might have ruled them out in the past.

While trials present risks, they have been shown collectively to improve outcomes for cancer patients and raise the quality of entire hospitals, said Dr. Mark Klein, a Minneapolis VA oncologist. "It's one of those all-ships-rise things ... They're able to get access to trials that are working, but they're also helping the entire system to be focused on improving their care outcomes."

The Minneapolis VA was one of 11 veterans' hospitals named this month to the NAVIGATE program, which should expand its access to federal trials. Klein said the prevalence of veterans with lung, prostate and bladder cancers makes it likely that the hospital will pursue studies in those areas.

Veterans have struggled in the past to participate in trials, which often have restrictions based on age and prior cancer histories — even if, for example, a prior localized skin cancer has nothing to do with a new lung cancer, Klein said.

Researchers generally need comparable patient populations to be certain that the drugs or treatments that they are testing are working, but the new VA partnership will re-examine restrictions to make sure they are necessary, Klein said. "You can sometimes have too many restrictions."

Access to clinical trials has been a growing political issue. A federal "right-to-try" law was signed by President Donald Trump in May to increase access for critically ill or dying patients to experimental treatments.

Some have criticized the law for circumventing the "compassionate use" system in which the U.S. Food and Drug Administration already permits access to experimental drugs, but with caveats and guidance to doctors.

Klein said the new VA partnership would increase access to therapeutic trials, including personalized therapies based on patients' genetic profiles and immunotherapies that coax patients' immune systems to fight off cancers.

But it will also increase access to trials that look at community and public health efforts to prevent cancers, and at complimentary therapies that reduce the symptoms of cancer and the side effects of treatment.

A 2017 study led by a Seattle doctor promoted the idea that hospitals improve when they build up their access to cancer trials. Among the findings: cancer outcomes have improved the least among adolescents and teenagers, who also are the least likely to consent to clinical trials.

Jeremy Olson • 612-673-7744