Roche: bringing oncology innovation to light

Advances in our knowledge of molecular biology and new technologies could redefine approaches to scientific research and individualised patient care for cancer. However, the complexity of treating this disease will grow in tandem.

From chemo to immunotherapy

In the past two decades, the world of cancer care has made great progress due to the introduction of targeted, personalised treatments and more intricate diagnostic tools. Prior to this, chemotherapy was often the standard of care for most cancers, but its non-specific action damages healthy cells as well tumour cells. This often means patients suffer from side effects and reduced quality of life. By following the science, researchers now understand better than ever how cancer behaves, which has in turn allowed them to establish improved treatment approaches. Unfortunately, cancer cells are smart and in many cases have found ways of becoming resistant to these newer treatment options.

In the past 50 years we have seen significant improvement in terms of the survival of patients with breast, melanoma and other cancers. In the future, combination therapies will increasingly help to keep cancers in check by blocking their growth from different angles. The emerging field of cancer immunotherapy is especially promising, and we can be proud to be one of the leaders in this exciting area.
Severin Schwan, CEO, Roche

Currently, the focus of research is on combining specific therapies that act on different molecular targets. By combining two molecules that work at different points of a known cellular signalling pathway, for example, we can attack the cancer on multiple fronts at the same time. In parallel, researchers are also investing significant time and effort into identifying more targets through which to fight cancer. Harnessing the body’s own immune system – immunotherapy – is currently the most advanced and exciting of these new prospects. Many in the scientific community believe this will be a game changer.

Each person’s cancer is different

However, progress always turns up hand-in-hand with new challenges. Scientists no longer consider cancer as just one disease, but a collection of hundreds of diseases with different characteristics and genetic profile. This means that each individual cancer behaves differently and requires a personalised approach to management – see Figure 1, which looks at lung cancer, a great example of this.

Figure 1. The increasing complexity of disease characterisation in lung cancer

  • A decade ago, mutations were important in only around 1/3 of non-small cell lung cancer cases
    A decade ago, mutations were important in only around 1/3 of non-small cell lung cancer cases
  • Today, there are many known mutations that can drive the development of cancer...
    Today, there are many known mutations that can drive the development of cancer...
  • ...which can all overlap, significantly increasing the complexity of the disease
    ...which can all overlap, significantly increasing the complexity of the disease

Ten years ago, a couple of cancer-causing genetic mutations, i.e. EGFR and KRAS, were linked to about a third of non-small cell lung cancer (NSCLC) cases. Testing for these mutations was very important in assessing prognosis for the patient and determining treatment choice.

Today many more mutations and other disease-related characteristics (biomarkers) have been identified, such as ALK, PIK3CA and MET. To make things even more complicated, many of these biomarkers overlap each other. Expression of PD-L1, for example, may overlap with one or more of the genetically defined subsets of cancers, suggesting that we will need to test for an increasing number of molecular characteristics of a tumour. Consequently an even broader selection of treatment combinations will be needed to serve individual patient needs.

Exploding information

Scientists and clinicians are not only collecting more and more data on the different characteristics and genetic mutations that drive the development of cancer. There is now also a huge – and ever-increasing – volume of patient outcomes data from clinical trials and real-world studies, which collectively means that data analysis is becoming more complex. The challenge is making sense of this “big data” and spotting correlations and trends that could lead to better patient outcomes.

There is still so much more we can do – and need to do – to help patients even more. Advances in molecular biology, next-generation sequencing, big data and innovative diagnostics – to name just a few – are opening up a whole new world of possibilities to make cancer treatments even better. At Roche, we are committed to transforming cancer into a disease we can live with.
Severin Schwan, CEO, Roche

Next-generation tests and technologies

In April 2015, Roche established a strategic partnership with Foundation Medicine, a company that specialises in molecular information and genomic analysis. This collaboration aims to advance personalised healthcare by making use of molecular information and genomic profiles to better target cancer tumours. Roche has also started a number of other strategic partnerships and pilots to tackle some of the challenges and opportunities of collecting, aggregating and interpreting such information.  

Another area of great potential is sequencing. Right now it is not yet a standardized process and thus not yet in routine use in the clinic. So there is a need to bring sequencing into routine testing. Roche is building on its offering of molecular, tissue and immunodiagnostics systems and tests that are widely used in private and hospital labs to complement this with a next-generation sequencing solution.

Pooling the huge amount of information coming from our Pharma and Diagnostics divisions and translating it into meaningful medical solutions will be pivotal in bringing cancer care to next level.

Tags: Oncology, Science