ITOG is dedicated to improving the survival and quality of life among patients with thyroid cancer. As part of that mission, the Correlative Sciences Committee of the ITOG has thoughtfully developed a position statement regarding the need for robust correlative studies in thyroid cancer clinical trials to further improve the care of patients with this disease. Correlative science is used to reveal relationships between molecular biomarkers, such as changes in genes and proteins, and clinical outcomes. While meaningful advances have been made in treating metastatic and progressive thyroid cancers, it is evident that there is a need for less toxic and more effective treatments. The Correlative Sciences Committee outlines several key points in establishing strategies to coordinate efforts in achieving this goal.
One central issue raised in the position statement is that it is currently difficult to predict which patients are most likely to benefit, or suffer severe side effects, from a given therapy. The development of improved treatments will be enhanced if investigators are able to obtain correlative data at the time of drug initiation, tumor response, and escape/tumor progression. These data will facilitate studies to elucidate mechanisms of drug action and resistance and inform the development of thoughtfully designed clinical trials and individualized therapies. There is also a need for the development and validation of less invasive markers of tumor responses to enable collection of these correlative data. Acquiring tumor tissues from serial biopsies, along with the determination of plasma drug levels and surrogate markers in non-tumor tissues, may be shown to correlate with clinical outcomes providing insight into the drug interaction with the target.
Finally, the Correlative Sciences Committee stresses that clinical trials should be designed to not only assess outcomes and toxicities of a particular treatment, but should also clarify why a particular treatment is or is not effective in different subsets of patients. This additional insight ultimately increases therapeutic progress. The position statement encourages cooperation among funding agencies, researchers, physicians and patients in achieving this common goal of improved outcomes, reduced therapeutic toxicities and increased years of productive life.
The position statement was recently published in the Journal of Clinical Endocrinology & Metabolism and the full text is available at http://press.endocrine.org/doi/pdf/10.1210/jc.2015-2818. Please contact Matthew D. Ringel, MD for more information: firstname.lastname@example.org.