Asia-Pacific, as home to 50 percent of the world’s new cancer cases each year and with deaths caused by cancer expected to increase by 36 percent by 2030, has a pressing need for more patient-centric, data-driven, value-based, and precise solutions in oncology. Additionally, Asian cancer patients’ healthcare needs can differ greatly from those of their Western counterparts, making Asia-focused innovation in the oncology precision medicine space particularly important.
From Discovery to Diagnostics
Cancer is a field where precision medicine solutions are especially relevant. As Sizhen Wang of Genetron Health, a publicly traded China-based firm working on cancer genomics research and clinical applications, explains, “Cancer is a disease that is mutation- and genomics-driven. By conducting continuous innovation in the research and development of genomic testing tools, we will be able to essentially interfere in a different stage of cancer’s evolution.”
By applying genomics adequately to cancer, we will be able to turn it into a non-life-threatening disease
Wang believes that the application of precision medicine tools has the potential to transform the status of cancer. “By applying genomics adequately to cancer, we will be able to turn it into a non-life-threatening disease,” he posits. “Conducting effective management across the full cycle of cancer care – from early screening to diagnosis and treatment recommendations, continuous monitoring and continuous care – is essential to achieving that goal. If you can detect the cancer at an early stage, it can often be cured, or largely cured with a simple surgery.”
Oncology precision medicine also extends to target identification and drug discovery, where fellow Chinese outfit HiFiBiO Therapeutics has developed a single-cell technology platform for this purpose. CEO and CSO Liang Schweizer points out that “the traditional bulk analysis method is well-established and suited for diseases that are more homogenous, but cancer and some types of autoimmune diseases are well-known for being heterogeneous, i.e., you cannot look at the average of a mixed cell population to understand the biology, you have to look at the single-cell level.”
Asian Solutions
While precision medicine approaches stand to reshape the oncology landscape globally, Asia-specific solutions are needed which are better tailored to the genomic profiles of Asian patients. Sangrae Choe, CEO of Gencurix, a Korean company that has developed Asia’s first prognostic diagnostic test for breast cancer designed specifically for Asian patients, outlines the unmet need it was trying to fill. “The main differences between Asian and Caucasian breast cancer patients are that in Asia, 50 percent are under the age of 50. Finding the unique algorithm specifically engineered for pre-menopausal Asian patients was an important step for us and was crucial in confirming the accuracy of our test.”
Choe adds, “One of the main problems we encountered was that alternative tests were over classifying most patients into high-risk groups, in which patients are advised to undergo chemotherapy. Thus, patients were over-treated, with toxic results. Our prognostic diagnostic test accurately identifies low-risk patients that do not require chemotherapy. A key pillar to our success has been utilising open-source big data to discover unique unpatented biomarkers which are accurate predictors and highly detectable. We also look at developing early diagnostics through specific biomarkers.”
Finding the unique algorithm specifically engineered for pre-menopausal Asian patients was an important step for us and was crucial in confirming the accuracy of our test
Also in Korea, the government-led ‘K-MASTER’ project has created a database of 10,000 cancer patients’ genomic data to be used by both healthcare professionals for cancer diagnosis and treatment as well as private companies in drug development. Director Yeul-Hong Kim outlines K-MASTER’s scope and purpose thusly: “This project involves the next generation targeted sequencing and genomic profiling of tumour and circulating tumour DNA from cancer patients. We also connect this genomic data with clinical data by merging databases which can be utilised for new drug development and for prognoses. It is very important that we have a collaboration with pharmaceutical companies so that we can act as a bridge between patients and the developers of future treatments.”
Kim continues, “20 percent of the 10,000 people screened for our genomic data collection displayed a specific targetable mutation. About half of those patients can be treated with previously approved drugs, with the other ten percent being responsive either to drugs in development, or those that have been approved in other countries. Our project tries to connect those patients to clinical trials so that they can access these treatments. The remaining 80 percent of patients possess other mutations, not currently identified as specific targets for treatments. If a pharmaceutical company does find a new specific target, we can link up those patients to give them the best chance of finding a treatment.”
Bringing Therapies to Market
The most headline-grabbing innovation in oncology precision medicine is that of CAR-T therapy, whereby cells are taken from individual patients, reengineered, and then placed back in the same patients. These therapies have, however, garnered as much attention for their revolutionary technology as for their eye-watering price tags, costing hundreds of thousands of dollars for a single treatment course
Swiss giant Novartis has been at the forefront of CAR-T, a technology that the company’s head of oncology for Asia Pacific and country president in Singapore, Kevin Zou, describes as “the perfect example of truly individualised therapy.”
Partnering with regulators is important for cell and gene therapy because it is not the traditional ‘pill’ approach. As an individualised therapy, the existing regulatory framework is not always suitable, so we must support regulators with more information and expertise
He explains how the company has been actively collaborating with public sector actors to bring these therapies to market in the region. “Partnering with government authorities to advance and support the rollout of precision medicine therapies is an important priority for Novartis,” notes Zou. “We are the first Big Pharma company to significantly invest in pioneering CAR-T research and clinical trials and we have a lot of ongoing research to broaden its impact. We are exploring the use of CAR-T in different types of cancer too.”
Zou goes on, “Partnering with regulators is important for cell and gene therapy because it is not the traditional ‘pill’ approach. As an individualised therapy, the existing regulatory framework is not always suitable, so we must support regulators with more information and expertise. For the region, we can leverage our work with regulatory authorities in other regions, such as the US FDA and the EMA. We also build platforms for regulators like the Singaporean HSA to interact with other health authorities. In general, regulators are very eager to learn more about such new therapies and how to facilitate their introduction to this region. We see a fantastic window of opportunity to bring industry and government closer so that patients can receive the benefits of these therapies sooner.”
