Published 23 May 2019
Sascha Fauser, Global Therapeutic Area Head of Ophthalmology at Roche Pharma and Early Development (pRED), shares his insights on how personalised healthcare (PHC) can bring benefits to patients with retinal diseases. An M.D. by training, Sascha has been a professor of ophthalmology with many years’ experience in clinical ophthalmology and vitreoretinal surgery.
Sascha, can you tell us about the current early research and development work that Roche is pursuing in the area of ophthalmology?
Yes, certainly. Our focus in ophthalmology is on the discovery and development of transformational therapies for patients with potentially blinding retinal diseases such as neovascular age-related macular degeneration (nAMD), diabetic retinopathy and diabetic macular edema (DME). These diseases are incredibly common worldwide and may lead to permanent vision loss. This is a great unmet medical need that, if successfully addressed, could bring meaningful benefit to the lives of many patients.
You mention unmet medical need. However, aren’t there already effective therapies on the market for these eye diseases?
Indeed, there are clinically effective therapies available. One of them is anti-VEGF treatment. It leads to a resolution of fluid that accumulates in the retina from leaking new blood vessels in the eye. While these molecules have revolutionised treatment for many patients with retinal disease, a significant proportion of them have shown only partial improvement of vision, or none at all. And we now have real world data following patients for up to seven years. They clearly show that some fail to maintain initial vision gains observed in clinical trials. In that sense, there is a clear need to develop and deliver tailored treatments that are both more efficacious and more durable. We are already making significant strides toward the development of new combination therapies, and in harnessing innovative technologies such as gene therapy. We also believe Personalised Healthcare (PHC) can help chart the path in further optimising medical care in ophthalmology.
That sounds interesting. Why do you think ophthalmology is especially positioned to leverage PHC?
Across Roche, we have a deep interest and investment in PHC which also extends to retinal diseases. When it comes to PHC and ophthalmology, our overarching strategy is to use advanced analytics to gain new insights from advanced imaging (e.g. optical coherence tomography) derived from our vast databases of retinal images. Beyond that, molecular profiles of ocular fluid, as well as clinical and genomic data, also enable us to drive PHC in ophthalmology. Our strategy is based on and closely aligned with a growing body of evidence, including recent publications from our own Roche and Genentech colleagues. They showed that Artificial Intelligence could save people’s sight by helping clinicians diagnose retinal disease earlier and select the best possible treatments for individual patients more effectively.
There’s a lot of buzz around Artificial Intelligence and Machine Learning as analytic tools for large datasets. You talked about advanced analytics in ophthalmology, so how do AI and ML factor into this field of research?
As part of Roche’s large Ophthalmology Personalised Healthcare Initiative, we are exploring the potential to develop pilot Artificial Intelligence and Machine Learning tools that can sift through massive datasets to predict response to treatment, as well as the risk of disease progression. Also, the information yielded by diverse analytic tools may improve our ability to develop better treatments and help ophthalmologists deliver the right dose and treatment regimen to patients. I like to think of our PHC approach in ophthalmology as having a two-way benefit: both in clinical development and clinical decision-making support.
Our approach to PHC in ophthalmology may serve as a real-world proof of concept for how advanced analytics can be used to transform healthcare”
Can you expand on how PHC will help you to develop better therapies?
Our PHC approach means we will have a better understanding of and ability to predict patient response to treatment before enrolling them in clinical trials. This means we can implement leaner and more efficient clinical trials that require fewer patients. It also means that in the course of conducting clinical trials, we will have a better sense of which treatments are working well.
Clinical trials often require collaboration. How are you working with external partners to advance your vision for PHC in ophthalmology?
You raise an important point here. Partnerships and collaborations play a tremendously important role in everything we do in drug discovery and development, and this is particularly true in our PHC and ophthalmology work. In order to be able to compile the massive databases of retinal images, ocular fluid and the like, we have to partner with clinicians who collect these data at the point of care. There is also a need for partnerships with regard to the data science component of PHC. Roche has a strong track record of partnering for Personalised Healthcare, and though we are still in the early phases of recognising PHC’s potential to transform ophthalmology, I believe we are in a unique position at Roche to take advantage of all this knowledge. I’m also very excited to discover what our current and future partnerships might yield.
What else excites you about the potential for PHC in ophthalmology?
As both a scientist and an ophthalmologist by training, I am excited by our potential to gain a much deeper understanding of these debilitating retinal diseases. This will allow us to develop more effective therapies that will be better tailored to the patient’s individual needs, providing benefit over and beyond today’s standard of care. This will also empower clinicians with the decision-making tools to match the right treatment to the right patient at the right time. Our approach to PHC in ophthalmology may also serve as a real-world proof of concept for how advanced analytics can be used to transform healthcare, beyond our therapeutic area, and this excites me as well.
This has been a great introduction to your work and the promise of PHC. Is there anything else you would like to add?
Sure! At Roche, we have the opportunity to tackle challenging clinical problems with the resources and expertise to do it in a serious way. Our people are deeply passionate about both following the science, and bringing the latest technological innovations to bear in our work. With Roche’s growing number of PHC initiatives in ophthalmology and other therapeutic areas, we have an emerging need for state of the art data science and other highly specialised talent in PHC. So I encourage anyone interested in this rapidly evolving space to check out opportunities on our careers page.