Innovations in Clinical Research, Patient Outcomes, and Bladder Cancer - Dr. Guru Sonpavde @Dana Farber Cancer Institute

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This chat offers a lesson on some of the latest pressing issues and trends in clinical research, bladder cancer, healthcare quality, electronic health records, and pharmaceutical industry relationships with academia from Dr. Guru Sonpavde, a cutting-edge, innovative medical oncologist and Bladder Cancer Director at the Dana Farber Cancer Institute, Associate Professor of Medicine at Harvard Medical School, member of Southwest Oncology Group (SWOG) and Bladder Cancer Task Force of the U.S. NCI Genitourinary Steering Committee. Highlights/Timeline: 4:45 – Perspectives on the physician patient relationship and how it has changed over the years 5:20 – Shared Decision-Making with patients 6:30 – Are patients more demanding than ever today and as a result present a challenge to physicians? 7:47 – Role of Innovative Clinical Research on the continuity of care? 10:08 – Memorable stories of novel treatments transforming patients’ lives 10:42 – One of Dr. Sonpavde’s patients was thought to be terminal having undergone 3 courses of chemotherapy for a cancer that has metastasized. This patient participated in a Phase I trial that combined a novel immunotherapy with an existing immunotherapy treatment and was given a very low likelihood of response yet the patient is still alive today in complete remission 2-years post treatment. 12:20 – Is our healthcare system designed to give physicians enough time to review patients’ conditions to select the best course of therapy? It takes physicians a lot longer to enter data into EMR and requires more documentation than ever before 14:38 There is a huge unmet need in novel AI technology that is able to transcribe physician orders, comments accurately and patient level medical in order to close down the barrier between the patient and healthcare provider. 15:40 – Latest emerging treatments Dr. Sonpavde is most excited about in Bladder Cancer 16:23 – 1. Immunotherapy with Immune check-point inhibitors are a promising class of drugs that unleash immune T cells to fight the cancer in patients whose cancer progresses after the conventional platinum-based chemotherapy or even as first-line for metastatic cancer in patients who express PD-L1 protein or are ineligible for platinum-based chemotherapy. 2. Antibody-Drug Conjugates that are essentially a smart way of delivery of strong chemotherapy with more specific targeting of the tumor. 3. Erdafitinib, an FGFR3 inhibitor that works in patients who express this FGFR3 mutation that works in only 20 percent of patients. 4. Combining immunotherapy with Antibody Drug Conjugates is a very promising new approach 18:55 – Are there any particular new areas of research that are not addressed in bladder cancer? 19:31 – We still do not fully understand the biology of bladder cancer and have to improve our efforts in delivering the right treatment to the right patient - precision medicine. 1) We do not know who will benefit most from cisplatin chemotherapy 2) or who will benefit most from immunotherapy, and 3) we do not know the group of patients that will NOT benefit AT ALL from immunotherapy or chemotherapy because those are the populations that need the treatments the most. Thus we need biomarkers to predict tumor progression not just response to medication. 21:52 – What is Dr. Sonpavde’s opinion about invasive versus non-invasive screening/testing in Bladder Cancer? 24:32 – Are Bladder Cancer patients expecting simpler methods of screening and longer survival? 28:47 – How can the Medical Affairs and R & D division of the pharmaceutical and medical device industries improve the quality of research to anchor it to patient outcomes in the future? 31:00 – What is one detail about clinical research would you teach patients to better manage their expectations? 33:15 – Are we improving in the transparency and speed of generating and communicating clinical trial results in healthcare? 37:16 – What is one specific medication on which you are working on at the moment?