The promise of personalized cancer treatment, part II

August 13, 2013

CellToday’s Wall Street Journal includes a story about the dramatic genetic breakthroughs that are revolutionizing cancer treatment.

(The promise of personalized cancer treatment, Part I, can be found here.)

One of our portfolio companies, MolecularMD, provides highly validated, standardized pharmacogenomic tests that support regulatory approval and clinical adoption of targeted, personalized oncology.  Several of their assays help to identify a subset of the EGFR mutations mentioned in the story.

MolecularMD was founded by CEO Sheridan Snyder and Chief Scientific Officer Dr. Brian Druker.  Mr. Snyder is a renowned leader in the biotechnology industry and behind several previous successful start-ups in the field, including Genzyme (NASDAQ: GENZ) where he served as Chairman, CEO, and President.  Dr. Druker is a recipient of the Lasker-DeBakey Clinical Medical Research Award for his critical role in the development of Gleevec, a drug featured on the cover of Time magazine and described as a “magic bullet” that “convert(ed) a fatal cancer into a manageable chronic condition.”

(For those who would like to enjoy the inspiring story behind the development of Gleevec, please see A Doctor in Full from The Wall Street Journal and this interview in The New York Times.)

Here’s an excerpt from today’s story, DNA Sequencing of Tumors Brings Hope of New Cancer Drugs:

Kellie Carey’s doctor finally stopped dodging questions about how long she had to live six weeks after he diagnosed her lung cancer.

“Maybe three months,” he told her in his office one sunny May morning in 2010, she recalls.

Yet she is still alive, a testament to the most extraordinary decade of progress ever in the long scientific struggle against lung cancer.

Tests found Ms. Carey’s lung cancer to be of a rare type that researchers had found just three years earlier by deciphering its genetic code. The 45-year-old businesswoman in 2010 went on a drug Pfizer Inc. was testing for that type. By pinpointing her cancer, the drug probably helped give her years more to live than chemotherapy would have, her doctors say…

Ms. Carey has one of at least 15 lung-cancer variations, almost all of which scientists didn’t know existed 10 years ago. Researchers have identified those variations, most of them in just the past four years, by decoding DNA in tumors—akin to how crime labs analyze DNA to genetically fingerprint suspects…

Among signs that revolution really is afoot: A June 2013 study found that lung-cancer patients who were treated with drugs targeted at their genetically identified varieties lived 1.4 years longer than patients on chemotherapy whose cancers weren’t genetically identified.

In effect, lung cancer is no longer a few common diagnoses. Instead, it is a growing list of rare cancers, each a target for its own drug regimen…  The same goes for other malignancies: Scientists have decoded tumor DNA from breast, colon, kidney, skin and other cancers in recent years to discover scores of variations they didn’t know existed before…  (R)apid diagnostic advances are making it easier for any doctor to test for the newfound cancers. Tests now can hunt for more than 200 mutations—of lung and other cancers—in one biopsy.

In June 2011 the WSJ wrote about what this would mean for the approval process for new cancer-fighting drugs:

By targeting mutations, researchers say fewer patients will be needed to prove the efficacy of new drugs, hastening their path to the market. In addition, fewer people will be enrolled in trials of drugs that provide them little hope of benefit.

But the use in drug development of specific genetic traits in tumors, called biomarkers, poses a maze of challenges. Many tumors are complex organisms fueled by multiple pathways. When one is disrupted even by a potent single agent, others compensate to help tumors develop resistance to treatment. Target therapies will likely be more effective when given along with similar agents or as some are used now, with existing conventional drugs… Researchers and drug companies are already working to test combinations of targeted agents. In some cases, they are collaborating with rivals. Combining agents risks increasing side effects and the cost of therapy, researchers and regulators say, and will likely require changes to current procedures for approving drugs.

 

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