The National Comprehensive Cancer Network® (NCCN®) is an alliance of 27 leading cancer centers working together to set the standards of cancer care followed by clinicians around the country and the world. Thomas Flaig, MD, associate dean for Clinical Research at University of Colorado School of Medicine and Chief Clinical Research Officer of UCHealth, has been named chair of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Panel for Bladder Cancer, a group of 34 multidisciplinary bladder experts from NCCN Member Institutions specializing in the field of bladder cancer research, treatment and survivorship who will influence the future direction of care for the disease.
“After decades without new bladder cancer treatments, in the last two years and even more so in the last six-to-nine months, approvals of new drugs have accelerated. We’re finally getting traction against the disease. I’m honored to lead the NCCN bladder cancer panel through this important time of transition and opportunity,” Flaig says.
In addition to influencing how clinicians treat cancer patients, for example helping to decide what combination of drugs, surgery and radiation is appropriate for each kind of cancer and at which stage, NCCN Guidelines® often influence the treatments covered by insurance companies.
“The committee will have a key role guiding how these treatments are used,” Flaig says.
It is also the role of NCCN Guidelines panels to interpret the results of clinical trials through the lens of their own experience and expertise.
“Often there’s just not enough research to show exactly how every drug should be used in every situation. When that’s the case, we rely on expert opinion. The NCCN panels convene multidisciplinary experts – including oncologists, surgeons, radiologists, researchers and patient advocates – to offer our best recommendations for the use of anti-cancer therapies,” Flaig says.
Flaig describes bladder cancer as a “target-rich” environment, in which many genetic pathways and alterations can influence the development of the disease. Many of these genetic targets have proven important in other kinds of cancer, implying that the field’s recent acceleration may only be the tip of the iceberg of what is possible.
“One thing that the bladder cancer community has done is proven to industry and to the National Cancer Institute that we can set goals, complete clinical trials and discover new treatments that extend and improve patients’ lives. Now in addition to learning to use these medicines, we have the opportunity to circle back to discover new ones,” Flaig says.
For example, drugs currently exist targeting cells with specific alterations in gene in other cancer types. Now recent research is identifying these same genes as drivers of bladder cancer, suggesting that these same drugs could be adapted to use against this form of the disease.
“It’s a really exciting time,” says Flaig. “I like to think of it as a ‘happily complicated’ time as we have the opportunity and also the responsibility to improve the way things have always been done.”