Advanced lung cancer doesn’t stop Hamilton Health Sciences patient Sharon Amore from staying active and independent, including doing everyday tasks like cleaning her house. “You’d never know I have stage 4 cancer. I look and feel totally fine,” says Amore, who credits taking part in a clinical trial at HHS for her excellent quality of life.
For World Cancer Day on Feb. 4, HHS patient Sharon Amore shares how a clinical trial is helping her live well with advanced lung cancer
When Hamilton Health Sciences (HHS) lung cancer patient Sharon Amore was offered the chance to try a promising new cancer drug not yet approved for use in Canada, she was quick to say yes.
“I figured I had nothing to lose,” says the 75-year-old Hamilton woman, who was diagnosed with advanced lung cancer three years ago and receives care at HHS Juravinski Hospital and Cancer Centre.
HHS is a top five Canadian research hospital, and our patients are often the first to benefit from trying innovative new treatments not yet on the market.
HHS is a top five Canadian research hospital, and our patients are often the first to benefit from trying innovative new treatments not yet on the market. Amore was offered the opportunity to take part in a global, multi-site, Phase 1 clinical trial of the new drug by her HHS oncologist, Dr. Rosalyn Juergens.
“Our research wouldn’t be possible without our patient partners,” says Dr. Rosalyn Juergens, an HHS oncologist, cancer researcher, and medical director of trials. Juergens leads the HHS arm of the Phase 1 trial Amore is involved in.
Clinical trials are research studies that test new or emerging treatments. They may offer an option for patients when standard, approved treatments are no longer working or in this case when the standard treatments are not optimal.
Trials take place in phases so researchers can study their effectiveness in a gradual and safe way. Phase 1 trials help determine whether a medication is safe, how well it works against disease, the best dose to use, and what side effects may occur. Phase 2 trials look at effectiveness, often in particular subtypes of various cancers; Phase 3 compares the treatment being studied to the current standard treatments; and Phase 4 focuses on what happens in the long-term. HHS conducts trials in all four phases.
Juergens leads the HHS arm of the Phase 1 trial Amore is involved in. Amore joined in 2023, shortly after being diagnosed, and is one of eight HHS patients enrolled so far.
Living well with an incurable cancer
While late-stage lung cancer isn’t typically curable, treatments can help control the disease, relieve symptoms and improve quality of life.
Sharon Amore was among the first patients, worldwide, to try this combined treatment regimen through the trial.
Amore’s treatment combined the new drug being tested, which she takes twice daily in pill form, with immunotherapy — a Health Canada-approved type of intravenous therapy that ramps up the immune system to fight cancer.
She was among the first patients, worldwide, to try this combined treatment regimen with the goal of stopping cancer cells from growing while also boosting her body’s natural defenses. Amore finished immunotherapy last year, but continues to take the pill medication twice a day.
Sharon Amore’s treatment combined the new drug being tested, which she takes twice daily in pill form, with immunotherapy.
“The results have been absolutely magnificent,” says Amore, who credits her trial participation with being alive today and feeling perfectly healthy. “You’d never know I have stage 4 cancer. I look and feel totally fine.”
Treating a tricky gene mutation
The experimental drug Amore is testing targets a genetic mutation called KRAS G12C. (KRAS is the name of the gene, while G12C refers to a specific mutation buried deep inside it.)
“The results have been absolutely magnificent.” — Sharon Amore, lung cancer patient
The KRAS G12C gene mutation is found in non-small cell lung cancer, the most common type of lung cancer in Canada, accounting for 80 to 85 per cent of all cases. Approximately 20 per cent of non-small cell lung cancer patients will have the KRAS mutation and half of those patients diagnosed with non-small cell lung cancer have this KRAS G12C gene mutation, says Juergens. This mutation is one of the more common ones identified in patients in Hamilton diagnosed with non-small cell lung cancer.
A tough nut to crack
The KRAS gene itself acts like an on-off switch, telling cells when to grow and divide. Normally, it turns on only when needed and then turns off again. With the KRAS G12C mutation, that switch is damaged and stays stuck in the “on” position, sending constant signals for the cell to continue to grow out of control.
Just a few years ago, lung cancer patients with the KRAS G12C mutation had little hope. That’s because the gene’s “on” switch was hidden deep inside the protein, making it extremely difficult for cancer-fighting drugs to reach.
Then researchers made breakthrough discovery using a technology called X-ray crystallography, which lets them see the 3-D shape of tiny molecules like proteins and DNA. Using X-ray crystallography, they were able to spot a tiny, never-before-seen crack in KRAS gene’s outer layer.
“This crack became an entryway for new drugs to be slipped in, where they could block the protein’s signal and stop cancer cells from growing out of control,” says Juergens.
Expanding knowledge
The Phase 1 trial results have been so promising that an international Phase 3 study has been launched at sites worldwide including HHS. Patients are also being recruited for this trial, says Juergens. Phase 3 trials usually involve hundreds or even thousands of people across multiple hospitals, and patients are often randomly assigned to receive either the new treatment or the current standard treatment.
Showing gratitude
Juergens is deeply grateful to Amore and HHS patients like her who volunteer for studies. “Our research wouldn’t be possible without our patient partners,” she says.
All patients receiving care at HHS are automatically enrolled in Explore Research, the hospital’s patient recruitment process for research studies. Patients are notified about Explore Research during their hospital visit and can opt out at any time if they’d prefer not to be contacted about opportunities to participate.
Amore’s involvement has included spending full days at JHCC having blood drawn multiple times, so researchers could better understand such things as how quickly the medication took effect, and how her body metabolized it. It was a big time commitment, with routine, day-long visits during her first two years in the study.
“I’ve gotten to know the hospital staff really well,” says Amore. “When I visit the hospital it’s like an episode of Cheers. Everybody knows my name,” she adds, referring to popular 1980s TV show.
Amore especially looks forward to her appointments with Juergens. “She’s a wonderful, kind doctor. I feel like I’m visiting a friend.”
Juergens is also thankful to the HHS Foundation, which provided early-stage financial support for a set of lab tests identifying certain gene mutations including KRAS G12C. “The HHS Foundation’s support has been critical to our local advancement of knowledge about the drivers of cancer,” says Juergens, adding, “Our studies can offer hope to patients who traditionally had very poor outcomes.”
Juergens also recognizes the vital role of the Hamilton Integrated Research Ethics Board (HiREB), which reviews and oversees research involving patient participants to ensure it is ethical, safe, and scientifically sound, and research is conducted responsibly and ethically.
“HiREB’s support means that more of our patients can access clinical trials,” she says.
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