George Gauthier explains how a problem-solving approach is helping us write the future of breast cancer care.
George Gauthier, Franchise Head, breast and gynaecological cancers at Roche/Genentech, reflects on the extraordinary journey that the company has travelled since first becoming involved in breast cancer research over 30 years ago, and the hugely exciting potential destinations of the future.
"Back in the 1980s when we were just beginning to understand the full role that certain genes might play in cancer growth, in collaboration with other leading scientists we made a crucial breakthrough – identifying the role of the HER2 protein, which is found in excess in about one of every five breast cancers. For over three decades, we have explored the science of the HER2 pathway, and now today, people with HER2-positive breast cancer, a particularly aggressive type of disease, have a higher chance of survival, especially when treated early."1-2
Understanding the role of the HER2 protein was a crucial milestone contributing to the major shift in cancer management that we have seen in recent years, away from a one-size-fits-all approach and towards new standards of care that treat patients based on the unique characteristics of their disease.
"It makes me very proud to work for this company when I think about the pioneering research that led to so much progress", says George. “Particularly in HER2-positive breast cancer, where through targeted treatments, we have been able to turn HER2 positivity from a negative prognostic factor into a target that we can direct treatment against.”
For George, this tale of scientific endeavour is just one of the many inspirational stories that drives him, and his colleagues, forward.
“When you work in healthcare, you come across incredible stories every day, whether it’s cutting-edge science or profoundly moving personal accounts from patients, and I realised very early on that I wanted to help reveal those stories,” he says.
“When we think about breast cancer, it is incredibly personal. Everyone knows a mother or a sister or an aunt or a friend who's been affected by this. And if we are able to contribute to some of these stories, then that is extremely meaningful.”
George's team try to “solve the problems of the day,” which reflects our ever-evolving understanding of cancer and how to tackle it. Certainly, there are many problems in breast cancer that remain to be solved.
Breast cancer is the most common cancer among women in the world, and every 15 seconds a woman is diagnosed with the disease.3Unfortunately, over 600,000 women die of the disease each year.3While significant progress has been made in certain types of breast cancer, such as HER2-positive, significant unmet needs still remain in breast cancer care.
The good news is that we are in the midst of possibly the most exciting period in the fight against cancer ever. Advances in science in recent years have been matched by advances in technology, data collection and analysis, leading to an upsurge in scientific innovation.
“The molecules we are seeing in research and development at the moment are incredibly exciting, and give us hope that we can find new options for all women, beyond those who don't have HER2-positive breast cancer,” says George. “We are discovering innovative treatments, targeting new proteins and pathways, which can potentially provide real benefit for these patients.”
One of the most exciting areas of cancer research is combining different molecules to understand how together they might provide increased benefits for patients. Roche’s broad and deep portfolio of molecules and expertise creates a unique opportunity to explore this approach.
“The number of cancer therapies and investigational molecules Roche has under one roof, gives us a hugely exciting opportunity to investigate unique combinations,” says George. “We’re investigating multiple pathways with novel modes of action and the possibilities for bringing these together are incredibly exciting.”
The upsurge in scientific understanding in recent years has led to a “massive diversification of knowledge” George says, which necessitates stronger partnerships more than ever before. "Only by partnering with the brightest minds can we serve patients with difficult-to-treat diseases like breast cancer, both now and in the future." And it is not just about developing new treatments.
“As well as the clinical unmet need, there is a second major factor, which is unmet needs around access to care,” says George. “I really believe we can do great things around this in partnership with others, whether it’s supporting access to effective breast screening programmes and earlier diagnoses, or working to improve the overarching health ecosystem that women with breast cancer enter into after diagnosis. It’s about taking the more holistic view. It’s not just about cutting edge clinical care, it’s also about contributing to improving overall public health at the societal level.”
George says that the COVID-19 pandemic shone a light on some of the disparities and challenges of the current healthcare systems, but this may in turn help to expedite positive change in disease areas such as breast cancer. From embracing technology to help people gain quicker access to prescriptions, to conducting more remote consultations when necessary, the possibilities to bring in greater efficiencies, including faster and more flexible administration of medicines, are significant.
Whatever the future of the pandemic has in store, George is certain that it will not derail the energy and passion of his team and their focus on helping people with breast cancer.
Which brings us back to solving problems.
“The scale that we can apply to solving problems is really incredible,” he says.
Dawood S, et al. Prognosis of Women With Metastatic Breast Cancer by HER2 Status and Trastuzumab Treatment: An Institutional-Based Review. J Clin Oncol. 2010;28(1):92-8.
Kristeleit H, et al. Long-term Follow-up Data from Pivotal Studies of Adjuvant Trastuzumab in Early Breast Cancer. Targ Oncol. 2016;11:579-91.
Ferlay J, et al. [Internet; cited December 2020]. Available from: http://gco.iarc.fr/today/data/factsheets/cancers/20-Breast-fact-sheet.pdf