Genomics  in  Cancer:    Con.nuing  to  Push  the  Leading  Edge    

Hannes  Smarason    Genome  Sequencing  |Personalized  Medicine  |  Transforming  Health  Care  

Genomic  Knowledge  Drives  BeAer  Care  in  Oncology  •  Genomics  con6nues  to  make  impressive  progress  in  helping  to  prevent  

and  treat  cancer,  driving  pa6ent  care  and  improving  outcomes  across  an  ever-­‐expanding  number  of  cancers.  

•  Genomics  helps  a  growing  number  of  oncologists:  –  BeEer  understand  the  gene6cs  of  a  pa6ent’s  tumor;  and  –  BeEer  understand  how  cancerous  tumors  grow  and  spread  over  6me.  

•  Armed  with  genomic  knowledge,  oncologists  can  tailor  an6-­‐cancer  treatments  to  a  tumor’s  muta6ons,  targe6ng  the  cancer’s  Achilles  heel.    Well-­‐documented  successes  include  cancer  drugs  that  target  certain  genes  –  HER2,  EFG,  ALK,  and  others.    

•  We  see  great  strides  in  the  applica6on  of  genomics  to  cancer  care  on  four  major  fronts:  in  leading  medical  centers,  in  approaches  to  different    types  of  cancer,  in  cancer  preven6on,  and  in  clinical  trials.  

The  Applica.on  of  Genomics  to  Cancer  Care:  Part  One  

•  Evolving  from  ‘why’  to  ‘how’  at  leading  cancer  centers.      •  Leading  medical  facili6es  demonstrate  the  value  of  genomics  through  

accelera6ng  use  and  deployment  to  advance  beEer  care  for  cancer  pa6ents.    

•  At  top  cancer  care  facili6es,  genomics  has  become  an  integral  part  of  the  programma6c  approach  to  provide  cancer  pa6ents  with  op6mal  care  in  pursuit  of  the  best  outcomes.      –  The  ques6on  for  leading  medical  centers  globally  used  to  be  “Do  we  need  genomics?”  –  The  ques6on  now  is  “For  which  cancer  types  and  at  what  stages  of  cancer  diagnosis  and  

treatment  can  we  best  use  genomic  sequencing  and  analysis?”      •  This  is  an  evolu6on  from  “Why?”  to  “How?”    

at  a  very  fundamental  level.      

The  Applica.on  of  Genomics  to  Cancer  Care:  Part  Two  •  Expanding  the  applica=on  of  genomics  to  different  

types  of  cancers.      •  Researchers  and  clinicians  con6nue  to  publish  a  wealth  

of  informa6on  valida6ng  the  poten6al  of  genomics  to  improve  outcomes  in  diverse  types  of  cancer  pa6ents.    

 •  In  2015  alone,  highlights  of  these  advancements  include:  

–  Certain  prostate  cancers;  –  Brain  cancers;  –  Rare  types  of  pediatric  kidney  cancers;  and    –  Promising  targets  in  certain  non-­‐small  cell  lung  cancers.  

The  Applica.on  of  Genomics  to  Cancer  Care:  Part  Three  

•  Broadening  acceptance  in  cancer  preven=on.    

•  People  around  the  world  are  seeking  and  benefi6ng  from  gene6c  tests  that  reveal  their  personal  risk  for  certain  tumors  (such  as  BRCA  for  breast  or  ovarian  cancers),  aided  by:    –  The  expanding  educa6on  of  oncologists  and  physicians;  and  –  The  empowerment  of  knowledgeable  pa6ents.  

•  For  pa6ents  who  may  be  at  high  risk  for  certain  cancers,  genomic  analysis  –  by  comparing  an  individual’s  genome  with  databases  of  confirmed  gene6c  muta6ons  linked  to  disease  –  guides  appropriate  medical  decisions.  

The  Applica.on  of  Genomics  to  Cancer  Care:  Part  Four  •  Powering  clinical  trials  with  genomics.    •  Researchers  are  using  genomics  in  clinical  trials  to  deepen  analysis  of  the  safety  and  

efficacy  of  drugs  in  cancer  and  beyond.  Genomics  is  an  increasingly  integral  part  of  data  gathering  and  inves6ga6on  and  is,  in  some  cases,  used  to  screen  pa6ents  for  appropriate  trials.  

•  In  2015,  two  large-­‐scale  cancer  trials  began  with  the  bold  goal  of  substan6ally  advancing  the  use  of  genomics  in  cancer  care:  –  TAPUR  (Targeted  Agent  and  Profiling  U6liza6on  Registry),  an  American  Society  of  Clinical  

Oncology  (ASCO)-­‐sponsored  study;  and  –  NCI-­‐MATCH  (Molecular  Analysis  for  Therapy  Choice),  a  Na6onal  Cancer  Ins6tute  (NCI)-­‐

sponsored  study.    •  Both  trials  selected  an6-­‐cancer  treatments  for  a  specific  molecular  target,  

independent  of  tumor  loca6on  and  histology.    •  These  and  similar  trials  will  doubtless  provide  insighdul  informa6on  to  drive  the  

growing  use  of  genomics  in  improving  cancer  care.  

Genomics  Con.nuing  to    Improve  Cancer  Care  •  Genomics  is  helping  to  prevent  and  treat  cancer  at  an  accelera6ng  rate,  

suppor6ng  the  goal  of  oncologists  to  drama6cally  improve  pa6ent  outcomes.      

•  In  at  least  four  fron6ers  we  are  seeing  substan6al  progress  in  the  use  of  genomics  in  cancer  care,  including:  –  Expanding  use  in  leading  medical  centers;    –  Increasing  applica6ons  within  cancer;  –  Broadening  acceptance  in  cancer  preven6on;  and    –  Developing  use  in  clinical  trials.    

 

•  I  am  personally  commiEed  to  accelera6ng  this  genomic  revolu6on  to  drive  true  progress  in  improving  cancer  care  for  pa6ents  in  need  globally.