I entered medical school planning to do full-time research and quickly realised that by becoming a pathologist I could combine research with clinical practice. That was a turning point in my career.
I’ve always loved the contact with patients. It helped me understand the emotional impact on women anxiously awaiting the results of their screening for cervical cancer. More importantly, it also gave me the clinical experience needed to help develop national guidelines for managing and treating this disease.
For most of my 35-year career, the standard for screening was the Pap test. It has dramatically reduced the number of deaths from cervical cancer in the US and other developed countries. Studies have shown, however, that in up to half of women with high-grade cervical cancer precursors, the Pap test misses the disease.
In the 1980s, scientists discovered that HPV causes almost all cervical cancers, and just two types are responsible for about 70% of cases. That breakthrough opened up exciting new horizons in terms of prevention, treatment and detection for both patients and clinicians.
A trustful partnership between academia and industry
Advances in molecular screening technology followed, including a Roche diagnostic test that can reliably detect the DNA of the two most aggressive strains of HPV. But how could we translate that into clinical practice? Changing FDA-approved procedures for cervical cancer screening requires clinical trials on a scale no academic institution could afford. It was the right moment for a partnership. Roche decided to conduct the Athena trial in 2009, with over 47,000 patients, and gave me the opportunity to participate. I worked with very talented people at Roche to design the study protocol, analyse the clinical findings and present the results to regulatory authorities.
In 2014, the FDA approved the Roche HPV test for primary screening in the US. I am sure this is a paradigm shift that will save many lives. In addition to this new screening technology, physicians now have an effective cervical cancer vaccine for young women and targeted molecular therapies. It is incredible to think that we could practically eliminate this disease over the next two decades in many countries.
During my years of collaboration with Roche, I have been very impressed with the knowledge and dedication of the people. They have welcomed input from the academic world and treated me as a trusted partner.
And our partnership continues. I am now collaborating with Roche on evaluating other biomarkers that play a role in cervical cancer. This will give us added precision in detecting and treating this disease at an early stage.