World Cancer Day took place this week, and provided us in the pharmaceutical industry with a chance to reflect on how our ongoing innovative research can positively impact people with this disease.
The theme for this year’s World Cancer Day was “Reduce stigma and dispel myths about cancer”. Despite cancer affecting almost everyone directly or indirectly during their lifetime many misconceptions and misunderstandings remain about the disease and how it can be treated.
I would like to dispel the myth that cancer is a single homogeneous disease that simply manifests in different organs of the body. In fact, increased understanding of genetic pathways has enabled us to better categorise cancers based on the molecular nature of individual tumours.
This increased understanding has provided the opportunity to tailor potential treatment to specific cancers and expand the possibility for combination therapies that greatly extend treatment benefit. Gone are the days of ‘one size fits all’ treatments, and the shift toward targeted medicine using specific pathways is the new paradigm. For example, we can look to treat specific sub-types of broader cancer categories, such as HER2 positive breast cancer, EGFRm+ lung cancer, or BRCAm ovarian cancer.
Without doubt, the identification of the BRCA mutation, which is considered the first ‘breast cancer gene’, was the breakthrough moment in cancer biology that led us to think about defining the disease based on genetic background rather than tumour origin. The BRCA pathway is an important mechanism for DNA repair and mutations in this gene predispose individuals to certain types of cancer including breast and ovarian. The more recent discovery of the PARP gene, which is also involved in DNA repair, provided opportunities for a new therapeutic approach and AstraZeneca has been exploring this pathway as a potential target for synthetic lethality.
In reflecting on the progress that we have made over the past 20 years of cancer treatment I can see that considerable advancement has been made in understanding the biology of cancer. What’s more, by following the opportunities provided by scientific insights we have developed new diagnostic and treatment capabilities. In the future I envision that cancer will be entirely defined by molecular signature, allowing physicians to give targeted personalised therapy with the most clinical benefit and the least risk to the patient.
There is still a long way to go in dispelling the myth that cancer is a single disease, defined only by body location. Gaps in education around tailored, pathway-based treatment exist not just within the general public, but also amongst physicians and the broader oncology community, meaning that many patients are not getting access to the most appropriate treatment regimen.
Initiatives such as the recently launched EU Cancer Patient Bill of Rights, which includes “access to specialised cancer care underpinned by research and innovation” as one of three core principles may serve to improve shortfalls in education. World Cancer Day also provides an opportunity to highlight exciting new breakthroughs taking place in the field of cancer research, ensuring that we can deliver these disease-changing treatments to our patients to ensure they get the best care available to help them improve their lives.