Next-generation sequencing technology has triggered a revolution in genomics and personalized medicine. Its ability to generate a snapshot of different cellular processes has led to an explosion of applications especially in molecular oncology. We at Scientia were pleased to welcome to our luminary insight series, Dr. Maureen Cronin, Senior Vice President at Foundation Medicine and a pioneer in the development of molecular diagnostic methods for oncology. According to Dr. Cronin, though it is widely accepted that cancer is a genomic disease, there is a tendency to restrict diagnosis to hotspots or markers specific to a cancer type. While recent research strengthens the notion that molecular subtypes are not restricted to a specific cancer, current genome profiling methods suffer from limited biopsy tissue, the inability to address biomarker complexity and an underappreciation of insertion-deletions and copy number variations. Successful personalized cancer treatment must integrate genome technology with advances in biology, management information systems and clinical oncology.
Tunnel vision in cancer testing might lead to a few pennies saved in the short term , but also to false negatives. Targeted therapy based on a wide genome profiling will result in cost-effective, long-term patient management. A wide genome profiling approach to targeted medicine may be more valuable and lower long-term healthcare costs. Instead of using the conventional disease anatomical approach, a high complexity multi-analyte test that sequences the entire cancer genome will enable physicians to identify molecular subtypes that are outside the scope of limited testing. Unfortunately, pan-cancer testing does not fit into a traditional treatment paradigm-legacy framework for regulatory approval and clinical trials do not accommodate new diagnostic technology and genomic understanding. Educating physicians and payers about the need for pan-cancer testing is necessary to overcome barriers to entry for this ecosystem. We believe that the standard of personalized cancer medicine must be to provide a patient with his/her specific molecular cancer landscape. This may enable targeted therapies to be used across tumor types, resulting in long-term savings of indirect healthcare costs, in contrast to currently approved MDx tests where incentives are not always aligned with patient benefits.
Related post on how Dr. Maureen Cronin inspired Patrick Terry, Principal at Scientia Advisors
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