Tackling tumours together

Oncology is at a critical juncture. Propelled by cutting-edge advancements including genomic medicine, targeted therapy, blood-based screening and artificial intelligence (AI), the field sits on the cusp of a transformative era that could dramatically improve patient outcomes.

Delivering on this potential requires a new mode of interdisciplinary collaboration, in which researchers, clinicians, industry experts and policymakers work together to integrate advancements into clinical practice, ensure accessibility and affordability, and address the evolving challenges in cancer treatment and care.

Recognizing this imperative, Tecan held the Partnering for Progress in Oncology meeting over two days in Boston, Massachusetts, in May 2023. Co-organizing the forum with Nature Medicine, Tecan, a leading global provider of laboratory automation equipment based in Männedorf, Switzerland, aimed to bridge the disciplinary gaps, promote dialogue and foster collaboration among leading voices in academic medicine, industry and technology.

In so doing, the event sets the stage for continuing collective progress in cancer research and patient care. “We busted a couple of siloes,” says Achim von Leoprechting, chief executive officer of Tecan, and a former skin cancer researcher himself.

“Malignant snowflakes”

Vivek Subbiah, an oncologist and medical director of the Clinical Center for Targeted Therapy at MD Anderson Cancer Center in Houston, Texas, anchored the discussion around the vital needs of patients and the transformative potential of genome-driven cancer care.

Comparing tumours to “malignant snowflakes” — each with their own molecular profile and biological characteristic — Subbiah used the example of RET gene mutations and fusions to illustrate how even rare cancer types can now be quickly brought under control with the aid of tumour genome sequencing and targeted drugs.

In just three years, he and his colleagues went from first-in-human trials to tissue-agnostic approvals for a pair of RET-targeted therapies — a clinical and regulatory triumph. Subbiah wants to fast-track cancer drug development further, and to bring more innovative medicines to patients where they live, rather than requiring them to travel long distances to visit large academic hospitals.

“The way we conduct clinical trials has not changed for many years,” he says. But the rise of telemedicine, especially during coronavirus-related lockdowns, demonstrated the possibility of alternative research models. “Patients don’t need to come to the hospital,” Subbiah points out, adding that, especially, they don’t need to come to elite research centres like his own. “We need to move all this research to the community and take it to where patients are.”

Profile-raising

Alanna Church, a molecular pathologist at Boston Children’s Hospital, echoes the imperative of patient-centricity, particularly in the context of paediatric cancer care. Her research revolves around assessing the clinical implications of molecular tumour profiling in young cancer patients, a practice that is as-yet not routine.

However, as Church and her colleagues have demonstrated, proactive DNA sequencing of paediatric tumours can empower clinicians to identify potential targeted therapy options. “The foundation of any cancer plan is getting the right diagnosis at the beginning of a patient’s care,” she says.

For Church, that means using the latest technologies to accurately characterize known tumours. In some cases, industry is moving that diagnosis even earlier, deploying next-generation sequencing methods to identify the seeds of cancer before patients are even aware they have the disease.

Emphasizing this trajectory, Tecan invited the biotech diagnostics specialist Grail, headquartered in Menlo Park, California, to provide a keynote industry perspective to the discussion. The company’s ‘liquid biopsy’ approach involves searching the blood for fragments of DNA released by tumours. By analysing genetic markers, Grail’s tests can uncover the presence and distinct characteristics of more than 50 different types of cancer.

However, transitioning this technology from a research setting to broader implementation is a significant logistical challenge. “It’s really about scaling,” says Jeffrey Venstrom, Grail’s chief medical officer, underscoring the importance of automation and standardization to guarantee consistent and efficient testing procedures.

Equity and inclusion

Sasha Gusev, a statistical geneticist at the Dana-Farber Cancer Institute (DFCI) in Boston, emphasizes the need to address disparities in the accuracy and reliability of precision oncology tests, to ensure equal and unbiased treatment for all patients. In his research, Gusev has found that differences in genetic ancestry can bias the results of common assays used to inform the administration of life-saving immune therapies.

“It’s an unobserved confounder of existing biomarkers,” he says — but one that can be easily remedied, Gusev noted, with the appropriate datasets and analytical techniques. In a study published in 2022, he and his colleagues showed that correcting for ancestry among patients of African or Asian descent helped to predict which individuals stood to gain the most from immunotherapy.

Several speakers highlighted the potential for vast amounts of data, derived from a multitude of sources, to unlock novel insights and drive advancements in cancer care. Yet much of this information still goes unused, both in clinical practice and in drug development.

Kfir Schreiber, cofounder and chief executive of DeepCure, an AI-driven drug discovery company in Boston, is hoping to change that paradigm. “We are wasting a lot of resources, both time and money, without being able to test enough ideas to lead to the success that we need to see,” he says. Enter the latest in computational chemistry, to find new kinds of drug compounds, coupled with lab automation, to run huge numbers of experiments in parallel on the algorithm’s top predictions.

The fight against cancer also calls for new takes on drug delivery — a topic covered by Darrell Irvine, a bioengineer at the Massachusetts Institute of Technology in Cambridge — as well as new immune-directed treatment options for the myriad patients who currently don’t benefit from checkpoint inhibitors and other drugs that harness the power of the immune system to fend off cancer.

Oncologist Catherine Wu, chief of the stem cell transplantation and cellular therapies division at DFCI, is putting her hope in personalized cancer vaccines, a technology that she pioneered and that is now seeing a resurgence of interest from investors and drug companies alike. “The winds are blowing in the right direction,” Wu said. “There are lots of encouraging results.”

Speaking at the event in Boston, Wu was specifically referring to cancer vaccine research. However, her words resonate beyond this particular context, encapsulating the overall atmosphere of optimism that brings with it new understandings of how academia and industry can better work together as well as transforming corporate competition into collaborative partnerships. This spirit of congenial commitment to a common cause permeated the Partnering for Progress event and the ongoing plans that emerged from it.