Three ways we are using precision medicine to get ahead of cancer
By Hesham Ahmed Abdullah, Senior Vice President, Global Head Oncology, Research and Development, GSK
October 18, 2023
With the advent of targeted oncology therapies, great progress has been made over the past decade in our fight against cancer. Despite this however, a study last year found that the incidence of early onset cancers was on the rise as part of a global trend in which more people under age 50 are diagnosed with cancer due to a combination of risk factors.1
All of us working in oncology research and development are aware of the significant unmet needs that continue to exist across many cancer types. As a major player in the biopharma industry, we have an opportunity to meet these growing needs with a greater understanding of the mechanisms of disease, which in turn enables scientists and physicians to develop and tailor treatment options to better target and destroy cancer cells.
Twenty years ago, oncologists did not have the diversity of therapeutic tools available today. In particular, the last 10 years have seen an explosion in our understanding and application of mapping potential therapies to our genetic code to target and treat disease.2 While the ability to apply these learnings in limited patient populations is remarkable progress, we know one size does not fit all when it comes to medicine. Therefore, our goal is to continue to get the right treatment to the right patient at the right time.
Industry has created more accurate diagnostic platforms to identify cancer risk early and has pioneered discoveries in fields like immuno-oncology (I-O) that harness the strength of the body’s immune system to fight cancer.3 Additionally, we are leveraging technology to analyze and generate data to help us pinpoint those who may benefit most from treatment. It’s an exciting time to be working to advance treatment options for cancer patients and at GSK, we are harnessing the power of precision medicine to help us get ahead of cancer in the following three ways.
Biomarker testing, immune profiling and liquid biopsies
At GSK, we are exploring next-generation approaches across multiple areas of research, such as immuno-oncology, synthetic lethality and tumor-cell targeting therapies, to get ahead of cancer and to address significant unmet medical needs.
While one type of currently approved immuno-oncology agents called checkpoint inhibitors have dramatically improved the treatment landscape, these therapies are only effective in a subset of patients, and those who benefit may eventually develop resistance to treatment.4 More research is needed to improve outcomes associated with these approaches and to explore potential new targets.
One precision medicine technology that has evolved in particular – biomarker testing – is helping doctors identify the treatment plans most likely to work for their patients. Biomarkers are biological or genetic characteristics of the patient or their cancer that can be assessed to provide information about a patient’s specific disease or condition.5 Once the unique characteristics of a patient’s cancer have been identified, doctors can gain new insights, including what treatments to suggest, as some treatments may only work for people who have certain biomarkers. GSK is exploring the science behind predictive biomarkers to identify and optimize potential treatment strategies for the next-generation of oncology therapeutics in development.
Another key area of study is immune profiling: assessing a patient’s immune and tumor related factors that may help scientists better determine an individual patient’s likelihood of responding to I-O therapy. GSK’s recently expanded collaboration with Tempus, an AI-enabled precision medicine company, will play a key role in enabling informed acceleration of I-O drug development through improved clinical trial design, faster enrollment into clinical trials and additional translational insights on the expression of certain immune biomarkers.
Additionally, liquid biopsies, such as circulating tumor DNA (ctDNA) technology, are also playing an increasing role in cancer treatment. ctDNA is found in the bloodstream and refers to DNA that comes from cancerous cells and tumors. It can be used to help assist with patient selection, treatment optimization and even identify risk of early relapse.6 GSK incorporates ctDNA across our portfolio of sponsored oncology studies. We are also combining ctDNA data with radiologic and clinical data into an AI algorithm that could potentially better predict responses to certain cancer therapies, so subsequent treatment strategies can be tailored to the patient with greater efficiency.
That said, there is little value from innovation if patients cannot access it. While these advances exist, more needs to be done to ensure every patient has access to the latest standard of care and treatment no matter where they live, including biomarker testing, immune profiling and liquid biopsies. At GSK, we are participating in public and private partnerships that help reach the communities we are trying to serve and foster diverse approaches in patient education and care. As an industry, we must meet the patients that we serve where they are.
Drug development and design
Our work to identify and develop new treatment options for cancer only achieves its full potential if we understand how a given treatment works in diverse patient populations and when the patients who will most benefit from a therapy can secure access to it. It is a very exciting time in biomedical research and clinical drug development, specifically in oncology drug development. Never have we had this volume of biomedical and clinical data and the enabling technology to search for previously unknown patterns with patient response, patient profiles or biochemical changes. Access to this data may inform how best to identify patients who are most (or least) likely to respond to therapy. With these discoveries, we may also be able to integrate novel treatment options and novel combinations earlier into a patient’s treatment journey to improve long-term outcomes. Early screening and diagnosis of cancer is a critical step in this process. An earlier cancer diagnosis and intervention with targeted therapies may help improve long-term outcomes.7
GSK is also using human genetics and functional genomics to gain more insights into the role that certain targets may play in disease. We are currently looking at genetic variants that exist around the CD226 gene and their potential interplay with immune and cancer phenotypes. This can give us confidence that we are targeting the right checkpoints in the most appropriate way.8 Novel combinations involving immune checkpoints will hopefully increase the proportion of patients who respond to therapy and improve the durability of response.
By leveraging science and technology, we can better pinpoint cancer’s genetic signature, find new treatment combinations, and even match specific patients to the medicine that is likely to be most effective for their individual genetic information.
Artificial Intelligence-Machine Learning (AI-ML) and data science in oncology
Artificial intelligence is a core component of our oncology strategy because of the volume of data it can help us sort through, and the speed at which we can then sort through that data to generate insights. AI can help us combine very different types of measurements such as images of tumors from pathology slides, 3-D volumes from clinical imaging and genetic changes in the tumor from ctDNA. These different ways of looking at the tumor each bring a distinct perspective, and by combining them all with AI, unique insights can be unlocked. Thanks to our combination of one of the largest in-house AI teams in the industry and innovative partnerships, GSK is decoding this data with unprecedented speed, scale and precision.
Through a continuous, interconnected process across genetics, genomics, and AI-ML, we are ensuring our datasets can keep growing and become richer with time. One of the ways we are achieving this is by developing robust nonclinical cancer model systems that help us better predict how tumors behave in patients, in response to therapy and in turn, increasing our confidence in the translatability of our preclinical findings in early phase clinical trials of novel therapies. We can then take our learnings from lab to clinic to patients, at new levels of speed, precision and scale driven by the power of AI-ML. This opens up new possibilities in cancer research and motivates us to continue this work to accelerate advances in the field.
Key takeaway
Cancer continues to impact our lives in different ways, whether the diagnosis affects you personally, a loved one, a family member or a friend. For me, the work I’ve done over my 20-year career, as a physician-scientist, contributing to the research and development of nearly a dozen targeted cancer therapies has been informed and inspired by my own family’s experience with cancer. My father lost a three-year battle with colorectal cancer 15 years ago and my sister is an ovarian cancer survivor. These experiences, while deeply personal, have shaped how I show up each day firmly committed to advancing cancer treatments for current and future patients. How do you want me, scientists, physicians and the broader biopharma community to be there for you?
At GSK, we are encouraged and invigorated by the pace of our progress in understanding the genomic characteristics of cancer, developing innovative precision medicines to wage a winning fight and, ultimately, staying ahead of the disease, together. Yet currently, cancer collectively still causes 1 in 6 deaths worldwide.9 It’s why our scientists and clinicians are relentlessly focused on oncology R&D to ensure we continue to stay at the cutting edge of science, for patients, in this new age of technological possibility.
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