Date of preparation: June 2023
Dr Markus Kosch
Head of Oncology, Daiichi Sankyo
Dr David Harland
Oncology Medical Affairs Lead, AstraZeneca
Biomarkers have provided a breakthrough in cancer care because they identify the make-up of individual tumours — and the targeted intervention that could stop them in their tracks.
On average, someone is diagnosed with cancer every 90 seconds in the UK, notes Dr Markus Kosch, Head of Oncology at healthcare company, Daiichi Sankyo.
“Which means that every 90 seconds, a husband, wife, father, mother, sister or brother has their life turned upside down,” he says. “There are now 3 million people living with cancer in the UK, and this figure is expected to rise to 5.3 million by 2040. So, it’s something that affects us all — directly or indirectly.”
Biomarker testing to assess disease and determine treatment
Because cancer is so biologically diverse with a myriad of subtypes, it can be a challenge for clinicians to identify the best treatment options for their patients. However, thanks to advances in the understanding of tumour biology, an innovation called ‘biomarker testing’ is now accelerating the fight against cancer.
Biomarkers can detect whether a disease or condition is present, how aggressive it is, what is helping it thrive — and, crucially, what specific treatment would potentially stop it. They are collected via routine tests such as biopsies or blood tests. The information they produce has the power to revolutionise how we think about and treat disease.
For example, biomarkers identify a cancer’s ‘kryptonite’ — its weakness — so that specific tumour subtypes can be attacked in a more targeted way, making treatment more efficacious and, sometimes, side effects more tolerable.
Biomarkers can change both the narrative of cancer care and the trajectory of the disease.Dr Markus Kosch
Understanding biomarkers and how they advance precision medicine
Dr David Harland, Oncology Medical Affairs Lead at pharmaceutical and biotechnology company AstraZeneca, sees this as an exciting milestone in the field of oncology. “Biomarker testing is the emerging foundation of precision medicine,” he says. “You can’t deliver precision oncology treatment without an understanding and a breadth of biomarker testing.”
By studying different biomarkers — such as risk biomarkers, monitoring biomarkers, predictive biomarkers and prognostic biomarkers — clinicians can make better, more informed decisions for patients.
You can’t deliver precision oncology treatment without an understanding and a breadth of biomarker testing.Dr David Harland
For example, predictive biomarkers will tell them if a patient’s cancer can be treated by a specific type of agent, while prognostic biomarkers will indicate what an individual’s response to it will be. This can help avoid ‘overtreatment’— unnecessary and inappropriate medical care — in the interest of the patient, the physician and the healthcare system.
“At present, chemotherapy is the ultimate hammer to crack a nut,” says Dr Harland. “It wipes out everything in the hope that it also kills the cancer. However, precision medicine gives targeted treatment to the tumour — and only to patients who are likely to respond to it. Ethically, and from a health economic perspective, it’s the right thing to do.”
Looking at the role of patient groups and future of cancer care
As biomarker science advances, patients must understand its impact. “This is why the role of patient groups is so important,” stresses Dr Kosch. “For instance, we proactively work alongside organisations on initiatives that aim to improve patient outcomes through education and increased awareness.”
Dr Kosch believes that biomarkers can change both the narrative of cancer care and the trajectory of the disease. “Our vision is that, in the long-term, cancer will become a chronic disease, rather than a life sentence,” he says. “By enabling precision medicine, biomarkers are an important step towards transforming cancer from a life sentence to a chronic disease.”
Dr Harland agrees. “Our mission is to eliminate cancer as a cause of death,” he says. “We’ll only be able to do this with precision medicine. We’re now moving away from thinking of cancer as ‘location-based’ and more towards the biomarkers we want to target. There’s still a huge amount of work to be done, especially in developing biomarkers and precision medicine.