Professor Taskén addressed the packed-out hall at the Oslo University Aula on Thursday 16 February. The audience included Her Royal Highness, Crown Princess Mette-Marit, and leading figures from the life science industry, from both Norway and all over the world.
Professor Taskén’s talk focused on the growing field of personalized cancer treatments, how the process can be made more efficient, and what shortcuts we might be able to explore when it comes to developing tailored treatments.
With a growing burden of the disease – one in two people will now be diagnosed with cancer in their lifetime (Source: Cancer Research UK 2015) – it has never been more important to find new ways of fighting the disease.
Cancer is a disease of an individual, not a group
Professor Taskén discussed the fact that we are now able to understand the molecular causes for disease, but when we delve deeper into we realise that in many disease cases, such as cancer, we have a disease of an individual and not a group. Thanks to numerous mutations in each cancer patient’s genetic code, each will effectively have their own, unique version of the disease.
Evidence-based medicine has traditionally been the ‘gold standard’ when it comes to the treatment of diseases like cancer, however, with this better understanding of more precise medicine, a new approach is needed to continue developing and providing personalized, evidence-based treatments.
DNA Sequencing and targeted therapies
Tumor sequencing can help us to determine actionable targets, i.e. finding known genes that cause cancer with known mutations. In these cases, we can try and treat the patient with a known drug, thereby providing a tailored approach.
However, DNA sequencing presents a challenge, given the number of mutations that will be found in one patient. Not all mutations will necessarily be disease indicators. This creates a lot of ‘background noise’, making it hard to determine the genes that are actually causing cancer.
Challenging classic cancer treatment
Modern cancer therapy involves classic treatments; surgery to remove a tumor, irradiation and then cytostatic drugs to kill cancer cells. Whilst effective, these also come at the risk of killing healthy cells. This is where targeted cancer drugs, such as immunotherapy, which block tumor immune invasion and switch the immune system back on to fight cancer, come in. Building on this tailored approach, we can exploit all of these variations found in patients, to try and match their needs with the hundreds of existing therapies already in existence, in a precision medicine approach. This is of course a long process. How might this be speeded up?
Shortcuts to personalized medicine
One approach that NCMM is exploring is cancer drug sensitivity screening. Patient samples of cancer cells are directly tested against a library of around 400 known cancer drugs. Advanced robotics and assays can assist with testing hundreds of drugs, helping to produce data that shows patient sensitivity to certain drugs. This data is useful; clinicians can certainly act on these findings. However, we need more information if we are to progress with successful personalised treatments.
Improved pipeline of patient samples
We need a pipeline of patient samples ready for direct drug testing, which will help to test for effective drugs. Data collected from this then needs to be integrated with the existing data from imaging, biomarker analyses, genomics, transcriptomics, and all other formats. We also need to be able to properly model this data, and predict optimal combinations of drugs, as well as appropriate tests.
Precision medicine protocols
Precision medicine protocols are also needed; whereby collected information can be used in a controlled setting to assist clinical decisions on individualized therapy choices. This could mean that a patient donating a sample could actually benefit directly from their involvement.
Regulatory challenges
These effects can be challenging from a regulatory point of view; it might mean drugs used that have been developed for other diseases and possibly combining drugs that have not been tested before. This type of treatment is for patients who have exhausted every other treatment option available.
The future
The future of cancer research and personalized treatments is very bright. Five years from now, we hope to be making inroads into the test stages of these different testing and treatment pipelines. Ten years from now, we hope to know how much patient benefit has been gained from these efforts.
Personalized medicine will change how we view ‘evidence-based medicine’. It will not only be possible to determine whether a treatment is effective for anybody, but also to determine who will actually benefit clinically.
For the full Life Science event programme, visit the Oslo: Life Science website.
Dagens Medisin - feature
Professor Kjetil Taskén’s talk from Day Two of the Oslo Life Science Conference has also been featured on the independent Norwegian health website, Dagens Medisin.
His presentation, focusing on the potential of personalized medicine, and how we might be able to speed the process up, comes at a time when new ways to diagnose and treat cancer have never been more important.
Read the article in full here (in Norwegian)