Precision Medicine is Transforming Cancer Care
Every fall marks a series of cancer awareness months — Prostate Cancer Awareness in September, Breast Cancer Awareness in October, Lung Cancer Awareness in November. This year, we ought to celebrate the significant decline in mortality across each of these diseases – due in part to lifestyle changes, early detection, and better treatment options – but we must also consider how sophisticated technology and personalized treatment options are enabling more people with advanced cancer to manage and live with their diagnoses for the long-term.
Take the story of Patty Watkins. Patty was only 57 years old when she heard the words no one ever wants to hear: “You have cancer.” Despite being a non-smoker, she was diagnosed with Stage IV lung cancer, and the doctor told her she only had a few months to live. But what happened next helps shed some light on how we are increasingly able to treat advanced cancer as a chronic disease rather than an end-of-life sentence.
Faced with a late-stage cancer patient hoping to make it to her son’s graduation, Patty’s doctor jumped right into an aggressive chemotherapy treatment plan. After several months, however, it was clear her condition was not improving. That’s when her doctor recommended Patty undergo full biomarker testing – otherwise referred to as comprehensive genomic profiling (CGP) – to understand the genomic makeup of her tumor.
This testing was critical. While two individuals may have the “same” cancer diagnosis, their tumors are likely to have different mutations – and that means they should receive different treatments. Patty discovered she was positive for the ROS1 mutation, making her a candidate for a targeted therapy.
Shortly after her physician prescribed the companion drug for the ROS1 mutation, Patty’s condition improved. Over time, however, her cancer changed, and scans revealed new lesions. That’s when her doctor ordered another round of biomarker testing, and she enrolled in a clinical trial for a new targeted therapy. Three years later, Patty is not only alive well past her son’s graduation, she has also gotten to meet and spend time with her first grandchild.
To be clear, this isn’t a miracle story where Patty was nursed back to full health. Instead, Patty has learned how to manage her cancer and live with her diagnosis. Patty’s story shows how precision medicine – enabled by our ability to conduct biomarker testing safely and easily – is transforming the way we treat and manage cancer and ensuring more people with advanced cancer enjoy longer, more fulfilling lives.
In recent decades, there has been a massive acceleration in the number of FDA approved personalized medicines. In 2020, the FDA ushered in 19 new precision therapies, accounting for more than 25 percent of new drugs approved in the past six years. What’s more, these targeted drugs are typically not accompanied by the grueling side effects associated with chemotherapy and immunotherapy. And most significantly, they have been proven to be more effective than traditional treatments – in some instances doubling or even tripling the life expectancy of someone with advanced cancer.
Still, despite the pharmaceutical advancements, clinical adoption has failed to keep pace. Fewer than 20 percent of people with advanced lung cancer receive full comprehensive genomic profiling, like Patty. That means roughly 80 percent of those with advanced cancer don’t know if they, too, might be a candidate for a targeted therapy.
Until recently, it’s been difficult to collect this genomic information. Best practice was to rely on a tissue biopsy – a risky procedure – especially if the tumor is buried deep inside an already compromised organ. What’s more, it takes time – something advanced cancer patients don’t have. That’s why, when someone like Patty presents with advanced cancer, doctors too often skip biopsies altogether and jump right into traditional treatments like chemotherapy and radiation.
But today things have changed. We know that tumors shed some of their DNA into the bloodstream. And new liquid biopsy tests – including one produced by Guardant Health – use a simple blood draw to conduct comprehensive genomic profiling, making it faster, safer, and easier for all those with advanced solid tumor cancers to find out if they might be a candidate for a targeted therapy.
Cancer awareness months are an opportunity to take stock of the advancements that have been made in reducing these diseases. But they are also a time to address our shortcomings. The technology for safe and easy biomarker testing – and the use of precision medicine – is here. Now we must make it our mission to ensure all people with advanced cancer learn about the latest developments and have access to the best treatment options to help them manage these diseases.
Helmy Eltoukhy, PhD is Co-Chief Executive Officer of Guardant Health, a precision oncology company focused on improving outcomes across the cancer spectrum, in Redwood City, CA.
