The Issue with Tissue
At ASCO this year we expect data from numerous studies, with various outcomes, showing the role of personalized medicine in helping people with cancer. But delivering personalized medicine is far more complex than many might think.
There are specific challenges with each medicine, test and type of cancer. One challenge is particularly relevant for lung cancer. It’s one that I believe we need to solve in order to realize the promise of personalized medicine for this difficult disease.
Here are the basics:
Getting ahead of the issue
At Genentech, we’re already spearheading efforts to help medical professionals navigate the complexity of the testing process. We are educating pathologists and surgeons about quality biomarker testing, and we have experts in diagnostics working on a “biomarker panel” for lung cancer.
One potential solution is to standardize the way tissue is collected and processed. Standardization can help maximize the amount of tissue available for testing and reduce problems associated with tissue loss and compromised test results.
Moreover, clear guidelines that recommend which tests are likely to provide useful information based on risk factors and characteristics (e.g., family history, smoking history, ethnicity, etc.) could help doctors and patients prioritize tests.
Most importantly, we need to develop new types of diagnostic tests, such as “multiplex tests,” which can do more with less (we're starting to develop these alongside our medicines). Multiplex tests can measure multiple biomarkers in a single test using smaller tissue samples, or using samples like blood that are more abundantly available and can be evaluated repeatedly over the course of a disease.
Personalized medicine has changed the way we treat lung cancer. But there is still a lot left to do.
In order to make the vision of personalized medicine a reality, doctors, pathologists, industry and regulatory agencies will need to work together to address the “tissue issue.”
Dietmar Berger is Senior Vice President and Global Head, Product Development, Clinical Hematology and Oncology at Genentech. In this role, Dr. Berger leads the medical strategy for the company’s global clinical development portfolio for cancer medicines. Dr. Berger was formerly Vice President of Global Clinical Development for Genentech’s HER2 breast cancer franchise and was instrumental in the development and marketing approvals of two breast cancer medicines across three indications.
Dr. Berger has more than 20 years of experience in oncology research and development, including as Head of the Clinical Research Center at the University Medical Hospital, Freiburg, Germany. He has held leadership positions at several global pharmaceutical companies and also received the Cancer Award of the German Cancer Society for his research on angiogenesis. Dr. Berger has authored more than 40 scientific publications and five books.