Oncology partnerships lay the groundwork for personalised healthcare options in diverse healthcare systems worldwide.
Over his adult life, Dražen Jeleč has seen his homeland recover from years of warfare to become one of the most prosperous countries in Southeast Europe. But for all the great strides his country has taken, he feels increasingly dismayed at the persistence of cancer as a leading killer of his fellow citizens.
“Croatia has the fifth-worst cancer mortality rate in the European Union,” says Dražen. “Being Croatian, being a physician, being a Roche employee, I feel huge frustration with this situation. How can we build a bridge from the healthcare system of today to the healthcare system of tomorrow, where people with cancer live longer and healthier lives?”
For the last five years, Dražen has worked to build that bridge with colleagues at Roche and partners throughout the Croatian healthcare sector, first as Market Access Director Croatia and recently as Roche Pharma International I7 NEO Integrated Disease Solutions Leader. In July 2019, prime minister Andrej Plenković and Roche representatives signed a Memorandum of Collaboration to provide personalised cancer treatment for 10,000 patients annually — and support prevention, screening and other efforts to reduce mortality. Today, teams from Roche and Croatia are hard at work setting up the clinical, technological and administrative infrastructure to implement the plan.
An emerging model of personalised healthcare is improving cancer treatment not just in Croatia, but around the world, by using insights from digital technologies and genomic testing, which looks for alterations in DNA driving tumour growth, combined with deeper scientific knowledge and consideration for each patient’s unique situation.
Because we believe that everyone should have access to this new approach to healthcare, we are partnering with local governments and hospital systems around the globe to help establish the infrastructure for personalised cancer care.
Compared with typical business agreements, these partnerships involve many stakeholders, including patients, providers, payers and regulators, who work together to fill gaps and find opportunities to improve treatment and patient outcomes.
“It really takes a village to come together to solve these diverse problems,” says Nathan Hubbard, Global Head, Healthcare System Collaborations. “I’m humbled by the efforts of our local colleagues to make bold, ambitious ideas a reality.”
No one knows exactly what results each experiment will produce, Nathan says. The intent is for everyone involved to learn how to contribute one element toward the shared vision of personalised healthcare for all patients.
In Croatia, the goal is nothing less than a complete transformation of the way cancer is treated, especially in its most advanced stages. In traditional cancer care, patients progress through standard treatment regimens based primarily on the location and growth characteristics of their disease. But the emerging personalised approach focuses instead on the biological roots of each patient’s disease, which may differ dramatically between people who have otherwise identical types of cancer. This model requires fundamental shifts in the way healthcare is delivered and managed to prioritise widespread and secure collection of anonymised data (e.g., genomics, symptoms, treatment details, outcomes) aimed at finding the best possible treatments for each patient and to learn over time from each patient’s experience.
“You need a comprehensive solution that includes testing, decision-making support tools for physicians, access to the right therapies and innovative funding models,” says Nathan. “You need to build the solution on a foundation of high-quality data from patients beyond clinical trials. And these things are all interconnected, so you can’t solve it piece by piece.”
The Croatia partnership calls for each party to supply vital elements of this comprehensive system. Working with Roche, the government had already ensured full access and funding of all innovative cancer treatments within a year of their approval by the European Medicines Agency. In April 2019, it committed to offer comprehensive genomic testing to all patients with advanced cancer, which gives oncologists valuable information about the patient’s disease at a molecular level and about potential options for targeted therapies. The intent of the project is to enable access to the therapy a clinician feels is best for the patient, regardless of the manufacturer.
Under the Memorandum of Collaboration, Roche will invest to build and scale Croatia’s personalised healthcare capabilities, including establishing the Unit for Personalised Medicine at University Hospital Centre Zagreb. The grant will enable training of more than 30 healthcare professionals to be employed at the Unit. Roche will also support the development of a secure, anonymised data repository* that will be used to better understand and address contributors to cancer mortality in Croatia.
Other partnerships focus on specific, aggressive types of cancer to improve outcomes among patients with especially high mortality. In Australia, for example, Roche has partnered with the Ministry of Health, the Australasian Lung Cancer Trials Group, Omico (formerly the Australian Genomic Cancer Medicine Centre) and the National Health and Medical Research Council (NHMRC) Clinical Trials Centre to support a clinical trial for patients with a certain type of advanced lung cancer.
In addition to potentially improving outcomes for a diagnosis with unusually low survival, this trial, co-funded by Roche and the Ministry of Health, will serve as a blueprint for how personalised healthcare can become a standard of care in treating cancer in Australia.
“In order to ensure that more patients with cancer in Australia receive targeted therapy, we need to promote equitable use of testing that can reliably identify the relevant genomic anomalies of tumours,” says Professor David Thomas, Chief Executive Officer of Omico.
In Taiwan, the focus has been on developing a database that can advance patient care and research — as well as the use of personalised data in managing the country’s healthcare. An agreement signed in November 2019 with Taiwan’s National Health Research Institutes will support the government’s creation of a database with patient outcomes that can be used for follow-up analysis and to provide evidence to support regulatory and reimbursement decisions.
“On the surface, these programmes look quite distinct,” says Richard Batchelder, Commercial Director, Personalised Medicine Global Market Development. “But underneath, I think you can expect to see similar changes in how these systems care for patients.”
As those changes produce results for Croatia, Dražen imagines his country serving as a blueprint for other healthcare systems around the world.
“Why are we doing this? Because we have a vision,” he says. “A vision to understand and to fight cancer, a vision to give the best tools to our physicians, a vision to make our healthcare system better and improve the survival of our cancer patients. Maybe we are biting off a bit more than we can chew. But together, we can chew a lot more than we can separately.”
*Roche Position on Data Privacy
The right to privacy is a fundamental human right. That is why the protection and responsible use of personal data is anchored in the Roche Group Code of Conduct and reflected in its daily operations. Roche is committed to collecting and using data in a lawful, fair and legitimate way, and it will always respect the privacy of individuals in order to earn and deserve their trust. Roche complies with all applicable data privacy laws including but not limited to the Swiss Data Protection Act, the European Union General Data Protection Regulation (GDPR), the US Health Insurance Portability and Accountability Act (HIPAA) and China’s Cybersecurity Law and associated data privacy standard.