Labiotech recently asked several biotech experts about fighting cancer the same question for a special newsletter to mark World Cancer Day on February 4.
The theme for 2023 is Close the Care Gap.
The question, What is the biggest opportunity to improve cancer care, brought responses from Versameb CEO, Klaas Zuideveld; ImaginAb CEO, Ian Wilson; ISA Pharmaceuticals Chief Scientific Officer, Kees Melief; Leucid Chief Scientific Officer, John Maher; CellCentric CEO, Will West; iOnctura CEO, Catherine Pickering; and Precirix CEO, Jennifer Wheeler.
Will West, CEO, SalesCentric
Improve quality of life. Feeling better, patients are able to live life. looking at more interventions that reach wider communities; Some new treatments and therapies are expensive, complex, and difficult to deliver. They only apply to relatively fit. Along with some of these great advances is the need for ‘real world’ medicines.
Catherine Pickering, CEO, iOnctura
New technologies are anticipating step changes in cancer care. A liquid biopsy that gives a range of information about the tumor in a simple non-invasive way is better for the patient than an invasive biopsy. They can be used to detect circulating tumor cells, or DNA, which provides an effective tool in cancer diagnosis and prognosis, enabling earlier therapeutic intervention and monitoring.
The potential opportunity to leverage AI in image analysis is also exciting. AI algorithms can be used to increase throughput through medical scanners and then analyze MRI, PET and CT scan images in ways that are faster, more accurate and provide insights into populations that cannot be seen by the human eye.
John Maher, CSO, Lucid
Despite considerable sustained efforts, the number of people dying from cancer is increasing every year in both developed and developing countries. The vast majority of these deaths afflict people with solid tumors, so that area is the greatest need.
When evaluating opportunities for improved care, a good place to start is to consider how we can prevent more cancers in the first place. This is especially appropriate given the ever-increasing trend in cancer diagnoses worldwide. Success calls for initiatives that help inform, encourage, and encourage the public to embrace healthy lifestyles and reduce activities linked to cancer development. Mature decision-making by governments is imperative as such interventions will pay short-term costs, but with the ultimate promise of long-term net payoffs to a healthy population and society.
We also need to acknowledge that access to standard cancer care is inadequate for most of the world’s population. Solutions have also been proposed to address this disparity, but implementation will require a globally oriented commitment from governments and other stakeholders.
Late cancer diagnosis has become a very important problem and this has been clearly exposed during the Covid pandemic. In the UK, it is sobering to note that more than a third of cancers are diagnosed in accident and emergency departments – a sobering statistic that highlights the urgent need for education at multiple levels. The potential impact is illustrated by the fact that patients with early-stage disease have a survival rate 13 times higher than those diagnosed with advanced cancer. In addition to education, the development and rollout of next-generation screening tools such as liquid biopsies offer the promise of early-stage cancer detection, where therapeutic intervention is most likely.
Another source of great opportunity arises from the abundance of new technologies now available. Better outcomes are promised because of advances in surgical technology, such as robotic approaches that improve precision and techniques that identify malignant cells in otherwise healthy-looking surgical margins.
Precision radiotherapy technologies allow radiation to be selectively delivered to tumor deposits with greater precision, increasing both efficacy and safety. Our expanding ability to interrogate the genetic and molecular blueprint of tumors offers the potential to better match patients with the growing array of novel and personalized therapies available. Artificial intelligence and machine learning technologies offer the opportunity to improve diagnosis and treatment selection on a global scale, as well as speed up the drug discovery process.
Over-treatment can be detrimental to treatment for patients and both of these technologies can help clinicians to strike the right balance more often. In response to the second question on this list, I describe the expanding role that another technology, immunotherapy, has played in the management of cancer and that I am confident will continue to provide great new opportunities for patient benefit. Telehealth is another effective technology that enables remote provision of increasingly standardized high-quality cancer care while the advent of nanomedicine allows new ways to improve both cancer imaging and drug delivery to malignant lesions.
Finally, I believe another huge opportunity will arise from the rapid delivery of new cancer drugs to the clinic, streamlining and standardizing the regulatory process worldwide so that disruptive therapies can reach patients faster.
Kees Melief, CSO, ISA Pharmaceuticals
Whole genome sequencing of cancer cells after diagnosis of cancer for each patient. The establishment of personalized targeted drugs and immunotherapies based on the mutations found in each patient’s cancer cells. Application of these treatments as early as possible in the course of the disease.
Jennifer Wheeler, CMO, Precirix
The greatest opportunity to improve cancer care lies in the development of regulatory pathways for individualized, “n-of-one” combination approaches. While biomarker-driven selection of patients has improved significantly, most patients will eventually develop resistance, and the vast majority require a combination of drugs to prevent resistance from developing—if not for cure, then for long-term, durable responses. While the pace and investment in the development of novel therapies needs to continue, it is also true that much can be made of currently available and approved drugs.
Instead of relying on a few academic centers where patients can be treated “off label” with a combination selected for their specific molecular and “omic” results, the improvement in outcomes will be significant when this model can be adopted within the regulatory structure, and when access. The results of these treatments can be provided.
In addition to focusing on improving cancer therapies, it is important to improve cancer care with a wider network of palliative care centers at the community level and access to in-home palliative care. Supporting improvements in end-of-life care, and bringing this stage of life into a more mainstream conversation is important. Working towards equal access to affordable cancer drugs is an urgent priority, just as it is a societal duty to ease suffering and make empowered choices for end-stage cancer patients.
Ian Wilson, CEO, ImaginAb
Cancer diagnosis should be early and accurate and more accurate to determine the right treatment for example the use of liquid biopsy based assays and whole body imaging are complementary tools to help early diagnosis and determine the right treatment.
This is a huge opportunity because many drugs work only in specific subpopulations of cancer patients due to tumor phenotype, tumor location and previous treatment cycles. For example, major breakthroughs in immuno-oncology have shown major improvements in life expectancy but only work in a subset of patients. Being able to select and monitor patients to determine when and if they should receive cancer immunotherapy and to highlight adverse events more quickly improves the management of these cancer patients.
ImaginAb Inc has developed an invivo imaging agent (CD8 ImmunoPET) that can detect a patient’s CD8+ T cells throughout their body. By doing so, it allows the physician to determine if and when to give immunotherapy, what type or combination to give, and provide an early study of drug action.
Klaas Zuideveld, CEO, Versameb
The biggest opportunities to improve cancer care that I see are in therapeutics, and especially new modalities like RNA, which can effectively address different tumor targets simultaneously.