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A new partnership to accelerate the potential of personalized monitoring in cancer

This article was originally published on LinkedIn.

ESMO is once again around the corner and with it comes the building anticipation for the data and discussions that will continue to shape the future of oncology.

This year’s theme, Translating science into better patient care, is particularly pertinent for me because I feel that it captures the essence of what personalized medicine can deliver and what lies at the heart of our mission here at Foundation Medicine.

True personalized medicine translates into better patient care on multiple levels:

  • At the individual patient level, it means diagnosing and treating each patient’s cancer based on the distinct mutations driving it; maximizing the potential for positive outcomes and improving patient care.
  • At the population level, the genomic data generated has vast applications for research that can transform our understanding of cancer and accelerate the development of new treatments; advancing patient care.
  • And the data can also be translated into better care back at the individual level again, by helping physicians to optimize treatment approaches in the clinic.

A personalized approach to cancer creates a feedback loop for continuous improvement in patient care. But that loop can only function with a constant supply of data; and that’s where the challenges currently lie.

Access to comprehensive genomic profiling (CGP) at diagnosis is still a significant hurdle, both in the US and the rest of the world, and improving access remains a key priority for us at Foundation Medicine.

But that’s only part of the story. The more data we can generate at each stage of the personalized medicine journey, the more opportunities we will have to advance patient care—and that is one of the many reasons why our partnership with Natera that we announced today is so exciting.

Natera is a leader in the development of new technologies that can deliver deeper and earlier insights into cancer treatment response, progression, and risk of relapse or recurrence. Our hope for this partnership is that together, we can develop and bring to the clinic a novel blood-based, personalized cancer therapy monitoring assay that combines our genomic insights with Natera’s circulating tumor DNA (ctDNA) testing technologies.

Molecular monitoring goes beyond traditional imaging techniques by detecting molecular levels of residual disease; therefore, treatment response can be defined at a much deeper level, signs of progression can be detected earlier, and the risk of relapse can be more accurately predicted. Ongoing molecular monitoring also means that treatment strategies can be optimized in real time to combat further mutations in the tumor, identify emerging neoantigens and detect new actionable mutations as they arise.

The potential benefits are clear, but so are the barriers that have so far prevented the routine use of molecular monitoring across all tumor types.

Ongoing molecular monitoring is currently only possible in cancers where the genetic marker of the disease is clearly defined and can be tested through minimally invasive techniques, and where standardization of testing has been established to allow reliable and consistent interpretation of results.

The difficulties associated with tumor biopsies at diagnosis in some patients and tumor types are well known, and it goes without saying that these challenges are multiplied when it comes to ongoing monitoring. In the diagnostic setting, liquid biopsy techniques based on the measurement of ctDNA levels are beginning to transform diagnostics for these patient populations. Expanding this technology into ongoing monitoring could have significant implications for patient care, and Natera has already demonstrated the clinical viability of this approach.

But what about defining disease markers across tumor types or establishing standardization of testing? That’s where we come in. By utilizing our FoundationOne®CDx as the baseline test, each patient’s personalized variants can be defined for ongoing monitoring using components of Natera’s Signatera™ ctDNA surveillance platform.

In theory, this is potentially transformative for individual patients, but what about the potential of this innovative approach at a broader population level? Currently there is little standardization when it comes to ongoing monitoring, and the generation and collection of data is patchy and inconsistent.

Using FoundationOneCDx as the baseline test in a new monitoring assay has the potential to harmonize ongoing monitoring across patient populations, tumor types and testing locations. This would make it possible to harness the huge volume of data that ongoing personalized therapeutic monitoring could generate; data that could give us unprecedented molecular insights into the impact of existing and investigational treatments in patient populations and tumor types where very little data currently exists.

My hope is that, by working with Natera and the whole oncology community, we can make this a reality and accelerate that feedback loop to terminal velocity. The result? Transforming science into better patient care.

I hope that ESMO is the first of many opportunities to discuss the potential of a new personalized approach to monitoring in cancer. In the meantime, I’d love to hear your thoughts in the comments below.