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The PancChat Podcast is a collaborative effort from Let’s Win Pancreatic Cancer and the Pancreatic Cancer Action Network (PanCAN), inspired by the long-running #PancChat Twitter/X chat.
Hosted by award-winning journalist Alisyn Camerota, each episode features conversations with leading researchers, clinicians, patients, and advocates who are shaping the future of pancreatic cancer care and research. Together, we deliver expert insights, personal journeys, and the latest breakthroughs—bridging the gap between science and lived experience.
Whether you’re a patient, caregiver, healthcare professional, or simply want to learn more, join us to connect, be inspired, and learn how you can help to accelerate progress in the fight against pancreatic cancer.
Cindy Gavin: Hi, everybody, and welcome back to the PancChat Podcast. January is Pancreatic Cancer Clinical Trial Awareness Month. In the next two episodes, our host, Alisyn Camerota, will meet with pancreatic cancer survivor Marty Hynes to discuss the challenges and barriers patients face in enrolling in a trial. Take it away, Alisyn.
Alisyn Camerota: Hi, everyone, and welcome to the PancChat Podcast. I'm your host, Alisyn Camerota. We want to thank our sponsor, Revolution Medicines, and thank you for being here. So today’s episode takes a closer look at the obstacles that prevent patients from joining clinical trials. I want to welcome our guest, Martin D. Hynes.
Martin D. Hynes is a PhD chemist who has spent most of his career in the pharmaceutical industry, including many years with Eli Lilly. While there, he was involved in the development of Gemzar. That’s one of the chemotherapy drugs used to treat pancreatic cancer. In 2021, he himself was diagnosed with pancreatic cancer and was forced to re-educate himself about this disease and its treatment. As a researcher and now as a patient, Marty has been on both sides of clinical trials. Marty, welcome to PancChat.
Martin D Hynes, III: Thank you very much for having me. It’s a pleasure to be here.
Alisyn Camerota: I've been looking forward to talking to you. So, I mean, Marty, you have an incredible personal story. If anyone, I would imagine, can be prepared to receive this very frightening diagnosis, I would imagine that it would be you, given your work experience in this field. But were you prepared when you got this diagnosis?
Martin D Hynes, III: Well, as you well know, right? The diagnosis is devastating. And so I think I was struck dumb after, you know, they came in from the emergency room scans and said, “You have pancreatic cancer.” And it was just like kind of this overwhelming emotion. And it really took me a few minutes to process that before I could start asking any intelligent questions.
In fact, it probably took me about a day or so. So when I was first diagnosed, I didn't even bother to ask where the tumor was, whether it was in the head of the pancreas, the body, or the tail, which obviously makes a big difference. But gradually, kind of once the emotions calm down, then you can kind of bring to bear your scientific expertise and kind of all of the privileges I've had over the years to be involved in clinical trials.
That started to kick in and was very helpful to me to begin kind of navigating all of this because it's overwhelming.
Alisyn Camerota: Absolutely. But I take your point that somewhere after the initial shock, in the recesses of your brain, you knew some questions to ask. Even with your experience, you were, of course, mentally and emotionally unprepared to get such a devastating diagnosis and, in the fog of that diagnosis, didn't know exactly what to ask.
But once you sat with it and processed it a little bit more, what was your tact to take? What did you think you should immediately do in terms of treatment?
Martin D Hynes, III: Yeah. There were kind of two things I thought I needed to do. One was find the right institution to treat me—so figuring out what's the best hospital system to go to to optimize my chances for survival.
So I spent a lot of time looking at the cancer centers across the United States, looked at all of the major ones, and kind of worked through that decision first and foremost. Once we had chosen—and I did that in cooperation with my primary care physician, who was really excellent in terms of helping me work through kind of the options of each one of those centers—then once we worked through that, it was looking at what's the best course of therapy.
Do we want to do chemotherapy, surgery? Are we looking for a clinical trial? Are we looking for a clinical trial now or at a later period of time?
So I kind of took it in a stepwise fashion, first getting kind of the institution, the surgeon, the oncologist that we thought would be the best for my particular condition, and then worked through with that medical team what is the best way to proceed with my therapy.
Alisyn Camerota: And Marty, can I ask what stage were you diagnosed at, and where was the tumor? In other words, on the scale of treatability, where was your cancer?
Martin D Hynes, III: My cancer was in the head of the pancreas, and it was very close to the bile duct, so it blocked the bile duct. I ended up with jaundice, which was kind of the key that got me diagnosed and got me diagnosed very, very quickly.
So that was kind of the key to getting rapid diagnosis—just the location, which caused the jaundice—and then ended up, you know, looking at treatment options after that.
Alisyn Camerota: And what stage were you diagnosed?
Martin D Hynes, III: I was diagnosed at stage IB—or initially at stage I—but then after I had a Whipple procedure, there was an invasion into one of the lymph nodes. So that escalated kind of the risk because of the involvement of that particular lymph node.
Alisyn Camerota: So how did clinical trials play into your treatment choices with your primary care physician? Was that one of your first priorities, or no?
Martin D Hynes, III: Yes, it was one of the very first priorities. So having done clinical trials, particularly clinical trials with pancreatic cancer, I was very interested in, you know, other clinical trials that might help because I knew advances were being made.
So I immediately started looking at what clinical trials would be available to me. I'm not sure whether I would need those immediately or at some point in time in the future, but I wanted to make sure I had thought through all of the different treatment options that were out there.
And as we began to gather more and more data on my clinical situation—germline mutations, tumor mutations—then that helped kind of narrow the field.
Alisyn Camerota: And were you inclined to do a clinical trial over the standard-of-care treatment?
Martin D Hynes, III: Yes, I was personally. And I tried to find trials that would take me, but unfortunately, at that period of time, there was not a trial that was willing to take me in as a patient because I didn't meet certain inclusion criteria at that time.
Alisyn Camerota: So let's talk about that, because that really is our topic today, which is the barriers of entry for patients to get into clinical trials. So you were not able to easily get into one, even with all of your experience and the help of your primary care physician.
Martin D Hynes, III: That is correct. And, you know, it's a lot of work, right? It's a daunting task. I think I've heard you on previous episodes kind of commenting on what a daunting task it is.
And even knowing what I knew—knowing how to get ahold of the right people kind of at the right hospitals—it's still very, very difficult. And so unless you meet certain inclusion criteria, you're not going to get into the trial.
Despite my best efforts to persuade them that I would be a good patient for their trial, they pretty much adhere to those inclusion as well as exclusion criteria.
So just to step back for a minute: every clinical trial protocol has inclusion criteria and exclusion criteria. And those would be the things that would get you into the trial or get you excluded from the trial.
So inclusion criteria for us would be certain things like a diagnosis of pancreatic cancer—that you've been diagnosed at a treatment center. And other things would be, for some of the KRAS trials you've talked about in previous episodes, the presence of a KRAS mutation—not only having a mutation, but specifically what type of mutation you have.
So those would be kind of very clearly spelled out, and unless you meet those inclusion criteria, they're not going to let you join that particular trial.
Alisyn Camerota: It's so curious, Marty, because you, I would think from a layperson’s perspective, would be a great candidate for a clinical trial because yours was diagnosed early and you were eligible for the Whipple. You know, you have a great chance of longevity and success.
So I would think a clinical trial would want you in it. But what was the problem? I mean, why were you excluded?
Martin D Hynes, III: Yeah. So I was excluded because I did not meet all of those inclusion criteria, right? So the trial is really set up to answer a specific scientific question.
And so a great deal of time and effort has been put into understanding who that will help the most, right? And so that ends up getting converted into these inclusion criteria. And if you don't meet them, it's very, very difficult, if not impossible, to get into a trial.
Alisyn Camerota: Did you ever get into one?
Martin D Hynes, III: No, I did not. I still continue to look for trials, right? So, you know, one never knows when one might potentially relapse.
And so I continue to look at trials all the time—one, because if I need one, then I've got kind of a head start—but I also work with other patients, right? I talk to patients here in the greater Indianapolis area and across the country and across the globe.
And it's always good to be able to help provide some direction to them as to what's available from a clinical trial perspective.
Alisyn Camerota: For sure. So let's talk about, I mean, I think you've spelled out the very real obstacles for patients getting into them. It can be quite selective. But let's talk about the misconceptions or the myths that discourage some patients from joining clinical trials.
What do you hear from patients or from doctors about why they wouldn't want a clinical trial?
Martin D Hynes, III: Right, there's kind of a lot of myths out there. I think a couple of the big ones are people are afraid they're just going to receive a placebo or sugar pill and their cancer won't be treated—and hence their chances of survival will be minimal.
And that's obviously not the case. Any clinical trial in pancreatic cancer, you will receive standard-of-care treatment. That may be FOLFIRINOX, that may be Gemzar plus Abraxane—you will receive that plus the study drug on top of that.
So under no circumstance will you just receive a placebo. That would be unethical, and there's no scientific institution in this country that would allow you to do that and treat patients.
So people need to understand that there's literally no risk that you would receive just a placebo by itself.
Alisyn Camerota: That's such a great one. I just want to stop you to underscore that. At worst, you'll get standard of care.
Martin D Hynes, III: That is so.
Alisyn Camerota: If you get—some of these things are, for lack of a better word, a lottery. You're randomized, I guess. And so at worst, you will get standard of care.
But if you get into the clinical—or the right arm, the preferable arm, I guess—you would get standard of care plus immunotherapy or standard of care plus a targeted treatment. So that's a really good one to debunk.
Martin D Hynes, III: That is correct. And that usually occurs in the latter stages of development, right? There's a stage I, II, and III of clinical development.
As you look at stage I and stage II, particularly for cancer patients, everybody is receiving standard of care plus the study drug.
By the time you get to the later stages, which is phase III clinical trials, everyone would still get standard of care but be randomized between the study drug and placebo.
And the goal of that is to show that the new treatment, in fact, has significant advantages over standard of care, because that's what everybody's looking for, right?
I think we know that the drugs that are currently used—the chemotherapy that we're currently using—are old, right? They've been around for a very long period of time.
Take a drug like 5-fluorouracil, which is kind of a standard part of FOLFIRINOX—that was approved by the FDA in 1962. So these drugs have been around for a very, very long period of time.
So people are trying to do better. We're looking for improvements over that standard of care.
Alisyn Camerota: Okay, so what's another myth that you have heard?
Martin D Hynes, III: Well, people are worried about being a guinea pig, right? That's something people worry about.
But I think what we need to do is assure them that any clinical trial is backed by an extensive amount of data. The sponsor—generally a pharmaceutical company—has done extensive research over years to show that this particular candidate will have advantages over the standard of care.
So they put together a package. That package is called an IND, or Investigational New Drug. In this country, that would be submitted to the FDA.
The FDA would review that. They have the option of rejecting it and saying you can't go on to clinical trials, or they have the ability to say yes, you can safely proceed to clinical trials.
So you've got the pharmaceutical company pulling this data together, you've got an extensive review process, and then the treating physicians—the physicians who are going to participate in these clinical trials—will also have had the opportunity to review all of this data.
So there's an extensive amount of data saying this is worth testing and that, from what we've seen to date, the benefits far outweigh the risks.
Alisyn Camerota: Yeah. I mean, with my husband, we just reframed our thinking about—yes, you're getting big.
I mean, it is true. They are testing something on you that has not become the standard of care yet. However, you're a pioneer.
I mean, that's how we saw it: we get this golden opportunity to be a pioneer for a breakthrough. That felt like a risk worth taking from our vantage point.
We felt lucky to be able to be on the cutting edge of these new treatments. And so a couple of other things that I want you to address is that people—sometimes patients—think a trial won't help. It has not been proven yet.
That's correct: that it will be risky, there will be more risks. So what about those concerns?
Martin D Hynes, III: Yeah, so, I mean, obviously there are risks in whatever we do, right? Any drug that you take has risks associated with it.
But as I mentioned, all of this extensive research has shown that the benefits outweigh the risks that we know of today.
As more people get exposed to the drug, you know, the risk profile will change. But nonetheless, we believe that based upon the data we have today, the benefits outweigh the risks.
And patients will be informed of the risk. So as you kind of go through the process, the study personnel will sit down with you and review those risks.
They will help you understand the risk. They'll help you put that in perspective.
And I think you're right: the way to look at this is as being a pioneer.
So if you go back to the 1950s in this country, when we were testing the Salk polio vaccine, all the kids who participated in those clinical trials had buttons that called themselves polio pioneers.
So I think that's a great way to frame it. I've not heard that before, so I applaud you and your husband for coming up with that reframing that I think helps put it in better perspective for patients.
Alisyn Camerota: Well, thanks, Marty. I have not heard of polio pioneers, so you taught me something, too. I didn't know that.
I mean, I think that helps me feel like we were part of a proud class of people who were willing to take that risk for others. And I still feel that way. So thank you for that.
Julie Fleshman: Hi, I'm Julie Fleshman, President and CEO of PanCAN. If you or a loved one has been diagnosed with pancreatic cancer, navigating this journey can feel overwhelming, but you don't have to do it alone.
Be sure to explore resources available to patients and caregivers through Let's Win and PanCAN. You can find PanCAN at pancan.org and Let's Win at letswinpc.org.
Don't forget to visit PanCAN and Let's Win clinical trial finders for more information on clinical trials. PanCAN’s Patient Services can also run a personalized clinical trial search for you.
Together, Let's Win and PanCAN are committed to guiding you through every step of the pancreatic cancer journey—offering support, information, and hope.
In our next episode, we continue our in-depth conversation with Marty Hynes about the barriers patients face if they want to participate in clinical trials.
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