Targeted treatment for cancer has been hitting the headlines recently, boosted by significant industry, charity and Government interest and investment in this exciting field.
Personalised medicine (often also called stratified medicine) in cancer involves matching patients to treatments by looking at the specific molecular properties of a patient’s tumour. As it becomes cheaper, faster and easier to profile individual cancers, doctors and patients will be able to make treatment decisions with far better clinical evidence than in the traditional treatment model. Understanding tumours at a molecular level means we can identify which therapies are most likely to work and, vitally, which are not likely to be of benefit – patients will get more effective treatments, doctors will prescribe fewer drugs which don’t work for particular patients and payers could potentially save significant sums from the drugs bill.
All of this is hugely exciting for clinicians, researchers and, of course, for patients and their families. This technology is available now, albeit not widely adopted, and is being integrated into cancer treatment by forward-looking oncologists in countries across the world.
So the impact of personalised medicine for patients and their doctors is clear. But what about the other organisations working in cancer?
For charities, it has profound implications: for the big players like Cancer Research UK and Macmillan, personalised medicine will need to be woven into their patient information, fundraising, support services and policy work but the impact is probably greatest on the site-specific organisations like Breakthrough Breast Cancer or Bowel Cancer UK. As it becomes less important where in the body your cancer began and more important which molecular properties your tumour displays, will patients identify differently with their fellow sufferers? A HER+ ovarian cancer patient might have more in common with the HER+ breast cancer patient in the next ward than the HER- ovarian cancer sufferer in the next bed. Already there are forums and Facebook pages for people with particular genetic profiles, generally linked to specific therapies, and we can expect to see this trend accelerate enormously. For innovative charities who can see the potential of the coming revolution in cancer treatment, there’s an opportunity to stand out from the crowd and both reflect and anticipate the changing way patients will view their cancer journey.
And for the pharma industry, the personalised medicine revolution will be no less transformative. Off-label prescriptions of targeted therapies are set to skyrocket, with implications for how firms promote and sell their drugs. It’s not unreasonable to expect access to funding for expensive new treatments (such as the Cancer Drugs Fund in England) may well be tied to demonstrable evidence of potential benefit based on molecular profiling – essentially, show us the drug might work and we’ll fund it. For those involved in the value-based pricing negotiations, molecular profiling adds a whole new layer of uncertainty as drugs get used across more and more indications, demonstrating benefit in ever more specific sub-groups of patients.
The pace of change in molecular medicine is incredible – in just a few years, we’ve moved from gene sequencing costing billions and taking years to the same process taking days and costing just a few thousand pounds. In the very near future, we could be looking at genetic profiling in a day for under a thousand pounds. Now is the time to start thinking about what this means for you and your organisation.