Around 150 people came to the latest Precision Medicine Group Basel Area event at Launchlabs to hear presentations and discuss the topic "When will diagnosis be valued higher than treatment?"
We were pleased to have some real experts in the field present with Dr. Miro Venturi, Global Head Diagnostics Biomarkers at F. Hoffmann-La Roche Ltd, Diagnostics Division and Dr. Dr. Stefan Scherer, Head Academic Medical Innovation, Novartis as well as Peter Groenen Head of Translational Science at Actelion.
Miro firstly presented the oncology companion diagnostics landscape that is what many first think of when they think diagnostics and precision medicine. He then pointed out some of the challenges of this model and amongst other things indicated the current status and potential evolution in the field, with the increasing use of complementary diagnostics. Complementary diagnostics provide information about the status or progression of a disease and help to inform the dialogue between patients and physicians and understand the likelihood of response to a specific therapy, hence providing an additional aid in addition to current diagnostics tools. ”The future of precision medicine will be about understanding the patient’s journey and providing adequate diagnostics solutions throughout. Companion diagnostics – as we know these tools today – will evolve into a much more comprehensive multi-marker diagnostics approach, sustained by continuous monitoring of the patient’s disease”, states Miro Venturi.
Stefan continued the theme of needing a change to how diagnosis is done in developing the precision medicine concept. He began by explaining the extreme heterogeneity of cancer within a tumour and metastasis and across elapsed time leading to a poor understanding of disease and treatment. Inevitably the chances of a successful therapy choice quickly decline. Treatment success is context dependent and in order to capture the heterogeneity and complexity of cancer, treatment regimens / paradigms have to follow the concept by comprehensively assessing and characterizing the mutational landscape, expression profile and proteomics. Stefan did outline one hope for the future which was liquid biopsies. Taking blood over time during treatment is minimally invasive and offers a good surrogate for the tumour. This might be a way to better monitor treatment effects over time and allow for quick adaptations in the drug used before the tumour recurs and becomes treatment resistant. This isn’t the one drug /one test paradigm but continuous monitoring to reveal information about the changing disease, leading to choices between many different drugs. This is a paradigm shift as we could change treatment according to the molecular changes and follow the tumour evolution rather than wait for recurrence.
After the two impulse speeches there was a lively debate moderated by Hans Herklots (Capricorn One) with many interesting questions on ethics and regulations and lastly and perhaps most importantly the question was posed: "how will any change in diagnosis practice come into the clinic at scale?" It was clear throughout that a multidisciplinary approach to tackle this problem is needed as the answers cannot be found only by the diagnostic or pharmaceutical industry. "It's a shared responsibility for stakeholders involved to make this happen faster" stated Peter Groenen.
Were we able to predict a timeline for when diagnosis will be more valuable than therapy? Unfortunately, not at all, but the audience got a great insight into how much more complicated therapy vs. diagnostics is than just comparing the price of a drug to that of a test. Stefan Scherer also stated that one of the solutions may lie in the pharma industry, teaming up with other stakeholders to become solution providers. The event showed there was considerable interest in the topic of precision medicine and plenty of momentum in the Basel life science community, to find better solutions, building on an improved understanding of current challenges and limitations of classic paradigms.
We look forward to seeing more people at our next event.
Douglas Haggstrom on behalf of the PMGBA team