Penny Kechagioglou, Chief Medical Officer, GenesisCare
Cancer chemotherapeutics have become more complex and more expensive in the attempt to move away from ‘one size fits all’ therapies, to truly personalized therapies. To mitigate the cost of those therapeutics, we need to standardize our decision-making tools about optimal patient treatments, which will lead to better patient outcomes and reduction in wasted drug costs.
Predictive and prognostic genomic test scores are routinely used in clinical practice to determine the role of adjuvant chemotherapy after cancer surgery, in the case of breast cancer as well as colorectal cancer. Our vision at GenesisCare is to develop standardized cancer patient pathways, which integrate genomic testing, imaging and clinical data. By doing so, we can provide personalized cancer treatments, enroll patients into relevant clinical trials, and create a repository of clinical best-practice data. Tissue and liquid-based genetic tests provide clinically actionable results enabling clinicians to offer the right treatment at the right time and potentially reducing drug costs.
Radiomics and radio-genomics are research areas of great interest for GenesisCare. Radiomics links radiological characteristics with patient genomic profile and clinical outcomes. Machine-learning technologies can be used to enable accurate radiological diagnoses to be made faster, can support the shrinking healthcare workforce and may negate the need for many biopsies in the future.
"Tissue and liquid-based genetic tests provide clinically actionable results enabling clinicians to offer the right treatment at the right time and potentially reducing drug costs"
Relevant stakeholder engagement such as patients, carers and clinicians is key in driving personalised cancer patient pathways. In the case of clinicians, they are responsible for bridging the gap between the multi-disciplinary team discussions about patient care and the genomic profile of patients. They need dedicated time in their job plan to be able to perform those duties and analyze data in a meaningful way. Data analysis will lead to further clinical research into cancer treatment personalization.
At GenesisCare, we appreciate the important role of academia and universities in educating and partnering with clinician groups, enabling research and innovation. For that reason, GenesisCare UK has partnered with the University of Oxford and driving research and innovation, including research on new radiotherapy technologies, machine-learning, and artificial intelligence.
Cancer care personalization also includes radiotherapy techniques and not just drug therapies. Personalized radiotherapy is guided by the clinical, imaging, and genomic profile data of patients and relies on providers investing on radiotherapy technology and technological innovation. Adopting world-class image-guided radiotherapy enables better tumor coverage, more normal tissue sparing and less toxicity. Deep inspiration breath-hold technique during radiotherapy for left-sided breast cancers and partial breast radiotherapy techniques enable effective breast cancer treatment while sparing the heart and normal breast tissue respectively, from unnecessary radiotherapy. If we combine the use of molecular biomarkers and genomic data, we can predict response to radiotherapy and design clinical studies, looking at innovative ways to deliver breast radiotherapy, such as the use of preoperative radiotherapy in advanced breast cancer.