Expert Insights

Expert Insights

The Promise of Precision Medicine: Advances in Oncology Clinical Trials – Part I

The Promise of Precision Medicine: Advances in Oncology Clinical Trials – Part I
06 February 2019

As the Vice President Oncology Development at Synteract, Etienne Drouet has dedicated his life to finding a cure for cancer. With 25 years working in drug development in the pharmaceutical and CRO industries as well as investigational cooperative groups, Etienne was recognized in 2017 for his strong work ethic and contributions to the field, as a PharmaVoice 100 Clinical Expert. We sat down with him recently to get his perspective on advanced diagnostics, genomics, and precision medicine in oncology clinical trials. In Part I of this two-part interview, we asked Etienne about the promise of precision medicine and what needs to happen to make it a reality. 

How close are we to the promise of precision medicine?
Two decades ago, one of the first combinations of tumor mutation analysis and actionable treatment was tested in breast cancer. Patients with a tumor harboring the Her2 gene amplification were treated with Trastuzumab, a drug that selectively targeted this membrane receptor. The treatment drastically improved the prognosis of this subgroup of patients with the aggressive tumor.

Since that time, a number of other actionable mutation and targeted treatment combinations have been identified in other types of cancer. Today, the gene panel analysis is a fundamental step on which treatment decisions are based. In clinical research, new designs in basket, umbrella, and platform studies aim to more efficiently identify patients, tumor biomarkers, and genetic mutation with their respective matching treatments. Such designs are now widely used in drug development. In standard practice, the biomarker and gene panel analysis has been extended to multiple types of cancers, and is now a fundamental step after diagnosis to support treatment decisions. Progress achieved in gene sequencing technology has enabled these positive changes.

What needs to change for precision medicine to meet its promise?
Precision medicine is based on diagnostics. A targeted agent can only be prescribed to patients who have had the opportunity to be diagnosed properly.

Technical limitations also exist. For instance, frequent invasive procedures that may not be feasible for certain patients may be required in diagnostic stages. One example is the requirement for fresh tumor tissue samples. This may or may not be possible for certain patients. Further progress on the technology side, such as with liquid biopsy approaches, is required to address this challenge.

Join us for Part II of this interview to learn more about how advanced diagnostics are changing the playing field in immunotherapy.

To learn more about emerging trends and advances in immunotherapy and oncology drug development, visit our oncology and resource pages or sign up for our upcoming webinars on this topics. 

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