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Driving Progress in Cancer Treatment

Radiation oncologist Dr. Xinglei Shen discusses the latest clinical trials and importance of patient-centered research.
Dr. Xinglei Shen

March 14, 2024

Approaching cancer from diverse angles and perspectives is crucial for gaining a comprehensive understanding of the disease and optimizing treatment strategies. Xinglei Shen, MD, associate professor, directs clinical research efforts in the Department of Radiation Oncology. According to Dr. Shen, specialists in this department go beyond providing the highest quality and state-of-the-art radiation therapy services in the region. Their work accelerates progress toward more personalized and effective ways to treat cancer.

Spanning the research spectrum

Basic research and clinical research play complementary roles in advancing our understanding of diseases. Basic research lays the groundwork for longer-term scientific progress by fostering exploration and innovation. It allows scientists to explore unconventional therapies that may not have been previously considered. Gene editing techniques like CRISPR, which originated in the lab, have revolutionized cancer treatment in recent years.

In addition to treating patients, some physicians in the Department of Radiation Oncology also have their own laboratories. One of them, David Akhavan, MD, PhD, is genetically engineering immune cells to treat glioblastoma. This approach has revolutionized the treatment of some blood cancers, but to date has not yet been adopted in solid tumors like glioblastoma.

“The work taking place in laboratories like Dr. Akhavan’s contribute to the knowledge base we need to advance cancer treatment,” Dr. Shen said. “Our approach to cancer should encompass the full spectrum of research."

Partnering with another cancer center, researchers are also testing a tool that may help identify circulating tumor cells in bladder and prostate cancers. These collaborative efforts may pave the way for future clinical trials, underscoring the collective endeavor to advance cancer care.

Investigator-initiated trials

An investigator-initiated trial (IIT) is a clinical trial that is conceived and conducted by researchers at a particular institution. IITs are primarily conducted at academic medical centers like KU Cancer Center for several reasons including: 

  • Deep bench of experts: A multidisciplinary team of experts who can collaborate effectively to design, conduct and analyze clinical trials.
  • Robust infrastructure: KU Cancer Center has a robust infrastructure and resources dedicated to clinical research, including its Clinical Trials Office.
  • Vibrant teaching environment: Conducting IITs in this environment fosters a culture of innovation, collaboration and continuous learning.
  • Diverse patient population: Access to a broad patient pool enables researchers to recruit and enroll participants more efficiently, enhancing the feasibility and generalizability of trial results.
In contrast to industry-sponsored trials where pharmaceutical or biotech companies drive the research agenda, IITs are led by investigators who are usually driven by scientific curiosity, clinical observations or unmet medical needs. 
“These are trials designed and led by our own people,” Dr. Shen said. “It’s our science.”

In one such phase III trial, researchers are studying the effects of omitting radiation from the current standard of care for HER2-positive breast cancer. In the past, doctors treated cancer with the maximum dose of radiation that could be safely administered. But now, they're trying to personalize treatment more. They might give smaller, more precise doses of radiation—or even skip it altogether. More than 250 sites across the nation are participating in this study, which was started by a KU Cancer Center physician. 

In 2023, The American Society for Radiation Oncology (ASTRO) announced that Dr. Shen’s research proposal received one of the ASTRO-Myovant Sciences-Pfizer Alliance New Combination (Relugolix-Radiation) Therapy Challenge grants. Dr. Shen is comparing two different durations of giving relugolix, an oral drug already approved for the treatment of prostate cancer, in high-risk prostate cancer patients who are treated by radiation therapy. Dr. Shen hopes to strike the right balance between providing enough treatment to still be effective while avoiding excessive treatment that might lead to increased side effects or toxicity.

Other clinical trials currently enrolling patients include:

Harnessing data and patient perspectives

Data-driven insights serve as a cornerstone for improving care. Recently, Dr. Shen and his colleagues have been focusing on building a database that may help them identify trends and areas for improvement. The database contains patient data that can be used for analysis and research. 

At each visit to meet with their radiation oncologist, patients are asked to fill out a quality-of-life questionnaire. In addition, they are asked to assess their baseline financial distress before and after treatment. The team has collected a huge amount of longitudinal data, which can help physicians put patients at the center of their work, considering their values, preferences, and quality of life. Trends in the data may serve as a springboard for research efforts seeking to improve cancer care and patient outcomes. 

“This gives us a better understanding of the true patient experience,” Dr. Shen said. “We are always looking for ways to improve care.”

In addition, Dr. Shen and other members of the department regularly work with the cancer center’s patient research advocacy program, PIVOT. The program facilitates collaboration between cancer survivors, co-survivors and researchers, enabling them to collectively shape research endeavors aimed at enhancing treatments. According to Dr. Shen, working with patient research advocates ensures the cancer center remains dedicated to its core focus on improving the well-being of patients.

“How can we do better?”

From pioneering research in the laboratory to groundbreaking clinical trials challenging conventional wisdom, KU Cancer Center experts are shaping future cancer treatments. Many studies led by faculty are already open for recruitment, with more in the planning stages. Dr. Shen emphasized the commitment to continuous improvement, which drives faculty members to continue pushing for progress.

“It starts with asking ourselves, ‘How can we do better?’" Dr. Shen said. "We’ve evolved a lot as a department, and now we have the personnel and resources to pursue those ideas.”



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