The evolution of cancer treatment

(Second in a series)

The branch of science that deals with tumors and cancers is oncology.

A tumor is an abnormal growth of cells serving no purpose. It may be benign or malignant. A benign tumor is not a malignant one, which is cancerous. It does not invade nearby tissues or spread to other parts of the body the way cancer can.

Cells of the body have a tightly regulated system that controls their growth, maturity, reproduction and eventual death. Cancer begins when cells in a part of the body lose this control and divide and proliferate indiscriminately.

There’s a good thing taking place at Novartis Oncology, and that is innovation.

Senior vice president and Novartis Oncology global program head Dr. Margaret Dugan told Asian journalists during a recent media briefing in Singapore that Novartis Oncology has groundbreaking research that is advancing the science of precision oncology—the evolving understanding of how cancers develop at the genomic level and the ability to develop drugs that focus toward those targets.

A great leap forward

Dugan said: “Precision oncology represents a great leap forward in cancer treatment. Cancer treatments of the past were based on tumor type, body location and risk factors. Today, precision technology uses screening to identify genetic changes in cell pathways that have caused cancers to develop and targeting those changes to interfere with a cancer’s ability to grow.”

She enumerated four steps for developing precision oncology treatments:

• Identify the target protein that causes the pathway to malfunction, leading to the development of cancer;

• Create the compound that binds to the target, normalizing the function of the pathway;

• Consider combination treatment with other compounds that also target that pathway or target other pathways involved with the same cancer;

• Identify the right patient for the compound by using genetic screening to uncover the pathway mutations that have occurred with their particular cancer.

For multiple compounds, Dugan focused on lung cancer development, where she was instrumental in several key advancements including a breakthrough therapy status for ceritinib from the Food and Drug Administration in 2013, helping the drug reach approval with four months of filing.

This is not new to Dugan, who has worked as a clinical research physician at two major pharmaceutical companies developing photodynamic therapy in esophageal and bladder cancer and producing health authority approvals for such therapy, as well as temozolomide for primary brain cancer.

At Novartis, she has worked on many successful global clinical development programs and global approvals, as well as oversaw the streamlined transition of early developmental compounds to full development. Ceritinib, an inhibitor of anaplastic lymphoma receptor tyrosine kinase (ALK) for treating ALK positive nonsmall cell lung cancer, is a new example of precision oncology from Novartis portfolio. It is currently approved in South Korea and Singapore, with additional regulatory filing underway in Asia.

Most common type

Dugan said that almost 50 percent of patients with adenocarcinoma, a type of cancer that may affect various organs and the most common type of NSCLC, have a genetic mutation driving the development of their cancer. Novartis’ pipeline includes compounds that target at least six known genetic mutations in NSCLC, she added.

She concluded: “Novartis Oncology is mapping the path forward in precision oncology, with a deep expertise in genomic medicine and a commitment to increasing access to these medicines of the future. The benefit of precision oncology is that clinical trials can be designed for patients who are most likely to respond, yielding stronger signals and shortening the time to market for new therapies. Further, patients can potentially be treated sooner with drugs tha are most likely to be effective for the treatment of cancer, thereby overcoming drug resistance and leading to better outcomes.”

Novartis Oncology’s over 1,800 associates assigned in emerging growth markets like Asia-Pacific are inspired by cancer patients every day. This serves as their motivation to revolutionize their research, infrastructure and relationships in Asia to help patients live longer with a better quality of life.