The physician and pharmacologist Nicole Onetto is a member of the Board of Directors at the Basilea Pharmaceutica AG. In the Interview that was featured in Basilea’s annual report she talks about current challenges in oncology.
Great strides are being made in the long-term treatment of oncology patients. As an oncology expert, what do you find to be the most important advancements in the industry?
Nicole Onetto: We see spectacular results in terms of long-term survival in quite a few diseases where, less than ten years ago, there were no new treatments available. And for many forms of cancer, where previously we had only access to traditional therapies such as surgery, radiation therapy and chemotherapy, we have been able to take advantage of the new molecular understanding of cancer to personalize the treatment for each patient. This has facilitated the development and the utilization of targeted therapies associated with superior efficacy and reduced toxicity compared to traditional treatments. Finally, in the last few years, we have been able to harness the potential of the immune system to develop new therapeutic approaches which stimulate our own immune defenses to control cancer growth.
What do you see as the next major treatment improvements that may be achieved in the short and mid-term?
Definitely the further development of immune therapies for cancer patients seems more and more important. These new modalities will need to find the right place in the management of patients and will have to be used in combination with more traditional therapies. The cost-effectiveness of these innovative technologies will also need to be evaluated. Another very important topic will be minimizing toxicity of treatments and avoiding over-treatment.
How can companies succeed in clinical development?
With a more personalized approach to cancer treatment, new opportunities do exist to develop drugs associated with high efficacy in well-defined patient populations. However, drug development will always require patience, perseverance and scientific rigor. Many challenges still remain in treating cancer patients, despite the important progress that has been made. Among others issues, drug resistance is a significant hurdle and continues to be in the focus of Basilea. For patients with resistant diseases, not so long ago, the only possible approach was to change to a new drug, often a new chemotherapy. Now we have gained more insight into the mechanisms of resistance. In addition, many researchers all over the world are investigating the best ways to circumvent treatment resistance. Other important factors are collaborations between academia and the private sector such as companies like Basilea, to develop new innovative drugs to benefit patients.
How can this be supported?
The use of biomarkers to help choose the most appropriate treatment regimen and to select the patients with the highest probability of response to treatment has and will continue to have a major impact on the development of new cancer agents. Biomarker data are key to the design of development plans of new drugs and to go/no go decisions. These data are now often incorporated in the approval process and subsequent commercialization of new drugs. This approach, based on scientific evidence to select new drugs, is one of the major advances that are currently transforming the research and development process as well as clinical study methodology.
Do you see advantages for Basilea being located in Basel?
Basel has all the ingredients required to host a successful company: a vibrant research community, an international reputation of excellence in the pharma industry, a pool of talented people and a strong and stable economy. Basel is a leading life-science hub with the presence of an excellent university, the headquarters of established large pharmaceutical companies and many start-ups and innovative ventures. There are many similarities between Basel and the few well established biotechnology hubs in Europe and North America. This favorable environment has already helped Basilea build a very strong company and should continue to support its further success. So I am delighted to have been elected by Basilea’s shareholders as a member of the board and look forward to playing an active role in the Basel biotech community.