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Andrew Evens, DO, MBA, MSc, highlights key points presented during the 2023 Rutgers Cancer Institute of New Jersey’s Annual Oncology Clinical Practice and Research Summit, the clinical implications of these presentations, and lymphoma treatment innovations that Rutgers Cancer Institute is providing to patients throughout New Jersey.
Multidisciplinary and multi-institutional collaboration are key for driving innovation across oncology subsets and expanding access to high-quality cancer care, according to Andrew Evens, DO, MBA, MSc.
“We want to provide the latest and greatest standard of care [SOC] in the moment, but we’re always looking to the future and having access to novel therapeutic studies,” Evens said in an interview with OncLive® during the 2023 Rutgers Cancer Institute of New Jersey’s Annual Oncology Clinical Practice and Research Summit.
In the interview, Evens highlighted key points presented during the summit, the clinical implications of these presentations, and lymphoma treatment innovations that Rutgers Cancer Institute is providing to patients throughout New Jersey.
Evens is the associate director for clinical services at Rutgers Cancer Institute, the system director for medical oncology and the oncology lead for the Combined Medical Group at RWJBarnabas Health, and associate vice chancellor for clinical innovation and data analytics at Rutgers Biomedical and Health Sciences in New Brunswick, New Jersey.
Evens: Our summit has grown significantly. It’s in its third year. It’s a reflection of the newness of our oncology service line, which is running on approximately 6 years. [This meeting] is a network of 15 freestanding hospitals, [comprised of] 12 adult and 3 pediatric [centers], with several associated ambulatory care practices that span the gamut of pediatric oncology, adult oncology, hematology, surgical oncology, gynecologic oncology, radiation oncology, pathology, radiology, social work, etc., working together in a patient-centered way.
The summit provides an excellent platform of convergence of all these specialties and providers under 1 roof. It’s not just different subtypes of specialists. It’s also different phenotypes, meaning physicians, but also nursing leaders, pharmacists, administrators, and clinical researchers. Another important part [of this summit] is having people who work mainly in clinical practice side by side with clinical research staff.
At the core of what we do is the patients. We often say, "cancer doesn’t travel well," and "keep cancer care close to home." Another mantra we have is, "nobody should have to travel more than 15 or 20 minutes to receive outstanding cancer care." Our academic hub is in New Brunswick. It’s the state’s only National Cancer Institute [NCI]–designated comprehensive cancer center. However, we are continuously asking how we can port out this excellent science and clinical care throughout New Jersey. We do that through interaction, collaboration, and education.
That’s what this summit does. It brings clinical researchers, clinicians, nurses, physicians, and pharmacists together, [and it aligns] academic specialists with community oncology specialists, because we are one team. We are one RWJBarnabas Health and one Rutgers Cancer Institute. It’s important to align on all these aspects.
[The summit] was a 2-day meeting this year. We’ve expanded to 2 days because of the abundance of topics, as well as the multitude of experts we have. We covered a gamut of topics.
The first day was more focused on hematologic malignancies and cell therapy. There are different types of cell therapy, [which] is a [modality] where you [leverage] the patient’s immune system, whether you’re taking cells out of the body and putting them back in remanufactured, such as CAR T-cell therapy, or using immunotherapeutics to stimulate the patient’s immune system [with] bispecific antibodies.
We had a couple excellent presentations by Neil Palmisiano, MD, MS, director of the Leukemia Program [at RWJBarnabas Health], and Adrienne Phillips, MD, MPH, a recent recruit [to RWJBarnabas Health], who spoke about CAR T-cell therapy. Her primary practice is in Livingston, New Jersey, at Cooperman Barnabas Medical Center, and she also spends time at Newark Beth Israel Medical Center [in New Jersey]. Our goal is to not have our innovative, cutting-edge cancer care focused [only] around New Brunswick, but wherever the patients are. She’ll help us build novel cell therapy [programs] throughout northern New Jersey.
We also had a couple fascinating panel sessions to highlight our surgical oncology expertise on pancreatic cancer, bladder cancer, breast cancer, and liver metastases, including interoperative videos by some of the surgeons showing us their technical expertise, but also how they work together in multidisciplinary groups with medical oncologists, radiation oncologists, and everyone else. Every week, we have 17 tumor boards that are now virtual. That’s a way we continue [these conversations] before and after the summit. It’s not just a one-time conversation. We’ll have 30 to 40 experts to talk about patients, the complexity of each cancer case, and how we can work together to give the best possible SOC and look beyond the SOC.
We’re fortunate, especially in New Brunswick, to have experts in gastrointestinal cancer, genitourinary cancer, lung cancer, lymphoma, leukemia, etc. These are national and international experts who are helping get new medications FDA approved and who often know the data before its published. We’re fortunate to lean on their expertise and make sure it’s communicated throughout our oncology service line.
Several exciting aspects came out of this [summit] that emerged beyond the SOC. One was the highlight on cell therapy and immunotherapy that several investigators in hematologic malignancies and solid tumors talked about, [including] CAR T-cell therapy, bispecific antibodies, and antibody-drug conjugates. These medications are in the clinic now.
[These experts] also highlighted the unique resources and facilities at RWJBarnabas Health and the Rutgers Cancer Institute, mainly our own good manufacturing practice facility. That’s under the rubric of the Duncan and Nancy Macmillan Cancer Immunology and Metabolism Center of Excellence, where we make our own cell therapy in New Brunswick. We recruited one of the top cell therapy experts, Christian Hinrichs, MD. He works closely with Eileen White, PhD, a basic scientist, to help us find unmet needs. This is the only [cancer center] in New Jersey and one of a few in the northeast United States [US] to have this capability.
We were honored and pleased to have as our plenary speaker this year Norman Wolmark, MD, FACS, FRCSC, from the NRG cooperative group. He gave a talk that highlighted the achievements and accomplishments of the NRG and some lost opportunities to show how we can learn from our past and move the needle further and faster together. It was a fascinating history of breast cancer that he gave through his lens.
We’re fortunate, under the leadership of Howard Hochster, MD, FACP, to have access to many clinical trials. At Rutgers Cancer Institute, we have over 200 clinical trials that span the gamut of novel targeted agents, immunotherapy, and oral small molecule inhibitors. [These trials ask]: How do we use [these therapies] in a smart way, whether concurrently or sequentially?
We have one of the top precision oncology programs in the country led by Shridar Ganesan, MD, PhD, and we’re getting to the point where we can measure invisible cancer cells in the blood. One form of that is circulating tumor DNA. How do we package this all together so patients can get the right therapy at the right time?
[Another important aspect of this summit] was to show the clinical trial accrual across the RWJBarnabas Health oncology service line. [This] took a few years for Dr Hochster to construct, but now, several hospitals and practices throughout New Jersey are on a single institutional review board, have master contracts, and can open studies in days’ time. Whether [a patient is] in Jersey City, Livingston, Toms River, or Long Branch, they have access to the latest and greatest [treatments that are] not [otherwise] available in New Jersey and they are sometimes one of the few [patients] in the US, if not the world, to have access to these treatments.
Another critical component of clinical research is addressing diversity, equity, and inclusion disparities. Through Dr Hochster and all the investigators, nurses, and clinical trial staff, 45% of our over 600 accruals to clinical trials last year were minorities. That’s higher than the state average in New Jersey. [This proves] the point that we are bringing cancer care to patients and keeping cancer care close to home.
My specialty is lymphoma, or lymphoid malignancies. That often falls under 2 categories: non-Hodgkin lymphoma [NHL] and [classical] Hodgkin lymphoma [HL]. [These categories] highlight the scientific complexity of cancer care. There are over 80 types [of NHL], and if you look on 1 type, there might be 5 or 6 molecular subtypes. Lymphoma is the sixth or seventh most common cancer, so some of these [subtypes represent] less than 1% of all cancers. I, [along with] Matthew Matasar, MD, Joanna Rhodes, MD, MSCE,Claire Tiger, MD, PhD, and others have expertise. All we do is lymphoma, which lets us understand almost any subtype of lymphoma and access new therapies that we can bring to patients to keep moving the standard to more effective, better tolerated treatment.
We’re also interested in population-based and precision medicine. [We’re studying precision medicine] in HL. We want to find a certain molecular marker to tell us what [therapy] to give. [We’re asking]: Can we look at the history of clinical trials and results over time [to see] which patients benefit from which treatments? You can do mathematical modeling and decision-support decision making [to answer this question], but you need large amounts of data.
We founded a consortium, HoLISTIC, the Hodgkin Lymphoma International Study for Individual Care, which has an NCI grant with Susan Parsons, MD, MRP, [of Tufts Medical Center] in Boston, Massachusetts. [Through HoLISTIC], we’ve harmonized over 20,000 patients with HL through seminal clinical trials over the past 15 years to look at different therapies, patient characteristics, and prospective cancer registries that can [give us] the long view. We’ve started with prognostication, but our hope is that [HoLISTIC] will create models to guide patients and providers in making the best choices for effective therapy in the moment and help predict long-term adverse effects over time.