Dr. Angela Alistar, one of the leading research doctors of gastrointestinal medical oncology in the country, knows how Phase 1 clinical trials used to be viewed: They represented a last glimmer of hope for those already battling cancer with a promise to help those who will take it on in the future.
“It used to be that clinical research was saved for after you failed standard treatments,” she said. “We ran out of options: What should we do next? Now, it’s time for a clinical trial.”
Alistar, speaking at the ribbon-cutting for the opening of the Breakthrough Treatment Center on Wednesday night at Morristown Medical Center, said that’s no longer the case.
“With the pace of clinical development and new drugs and exciting technology, waiting until the last moment is not appropriate anymore,” she said.
“As a physician, I always look for early-phase studies because I know what standard of care can do. Unless I have a curative standard of care treatment, I’m not interested. I want to do better. I want to find a clinical trial that combines standard of care with something exciting that has promise. I’m always looking for, ‘How can we do better?’
“That’s what this unit is about: Not waiting until the last minute, but giving our patients the best options up front.”
The center, through a partnership with the Translational Genomics Research Institute, or TGen, an affiliate of the highly regarded City of Hope, and Origin Commercial Ventures, is bringing some of the most innovative and exciting new cancer treatment options to Morristown.
Morristown Medical Center President Trish O’Keefe said patients will now be able to get treatments at Morristown that they could get in few other places in the country. And get them in a community center that’s not only warm and welcoming, she said, but one that is close to home.
“This pioneering partnership has enabled us to focus on delivering, groundbreaking novel research to patients right in our community,” she said. “Most importantly, this partnership allows us to offer our patients access to more clinical trials earlier on the onset, potentially giving them the stronger chance of remission as well as survival.
“Our oncology program now offers approximately 70 clinical trials, including nine Phase 1 clinical trials, some of which are offered to only a handful of patients in the United States. We are proud to be among them.
“This focus on research is one part of our unrelenting commitment to creating a national model for cancer care right here in our own backyard.”
Dr. Eric Whitman, the medical director at Morristown parent Atlantic Health System, said having a Phase 1 unit such as the center will quickly become a necessity more than a novelty.
“Phase 1 drugs are revolutionizing cancer care,” he said. “They are drugs that go almost from the lab to approval. You almost don’t need later-stage studies because some of these drugs work so well initially, the FDA is able to approve them right away.
“Ten years ago, Phase 1 was like, ‘Oh, my gosh, I failed everything, what else can I do?’ But the science has advanced so much that I think our expectations are of what the Phase 1 drugs can do are much higher.”
Morristown has been recognized as the top hospital in New Jersey three years running, but many would be slow to think a community hospital could offer treatments and trials that even the top academic research facilities do not.
Brian Gragnolati, the CEO and president of Atlantic Health who came to the system from Johns Hopkins, used to think that way. Now he knows personally that community hospitals such as Morristown can compete with more renowned medical centers.
And they do so, he said, for two reasons: They have the patients and they are able to recruit the doctors to serve them.
“More and more care is migrating to community settings, because that’s where the patients are and care needs to be accessible,” Gragnolati said. “As cancer becomes more about survivorship and a chronic disease — which is what we hope will ultimately come: cure it or make it chronic, as opposed to a fatal disease — we’re going to see more and more patients who are living with this.
“So, it’s incumbent upon organizations like ours to make the kinds of investments in the talent that we have here. And what you see here today is a cadre of physicians who left pure play academic medicine to work in a community.”
The community atmosphere, Gragnolati stressed, is different. And better.
“What we’re trying to do is mix that culture of inquiry with the culture of caring,” he said. “And that’s really the secret formula going forward, because, here, you can get access to trials that you may not even be able to get to in (New York City).
“You can get stuff done easier. There are less hoops you have to jump through and there’s less of a bureaucracy where you work. And that’s attractive to a lot of physicians and the other team members who join us.”
It attracted doctors such as Alistar, a leader in pancreatic cancer research and treatment who came to Morristown from the Wake Forest School of Medicine. It was a move, she said, she wasn’t expecting to make.
“This is really a highlight in my career,” she said. “I never imagined I could do this in a community hospital. The best hospital in New Jersey, no less. It took a lot of courage to shift my career path. In retrospect, I’m so grateful I did that, because it was the right choice.”
One she gladly relives.
“The way I keep myself honest about why I do this and why I feel so strongly about clinical research and controlling patients in clinical trials, is that I ask myself, ‘What would I want?’” she said.
“I want to be positioned for success. So, a clinical trial is where I would go or where I would direct family at any cost. However, going to a clinical trial is a traumatizing experience for most patients, because they have to travel, figure out transportation, who is going to take care of the kids and the dogs, things like that.
“I thought the best way to do it would be locally.”
Community hospitals offer comforts and supports others don’t, Alistar said.
“Our nurses are really outstanding,” she said. “Coming from an academic research hospital, I can guarantee you that you can’t find better. They are surrounding our patients and supporting them emotionally.
“I always tell (my patients), ‘You are getting concierged clinical research support, because you wouldn’t get this anywhere else in the country.
“So, I’m excited to be here and excited to move the needle. As long as I can do clinical research, I’ll be happy.”
Alistar is just one of many renowned cancer doctors at Morristown.
Whitman knows the Breakthrough Treatment Center will allow it to attract many more.
“Like many others in our program, Angela has realized that, as a doctor at Morristown Medical Center you can continue to be a scientifically active innovative, creative cancer physician, just like you were at a university,” he said. “And, frankly, in a much nicer environment.”