The next generation toolkit in the tough fight against cancer: targeting, personalisation and collaboration are key

Today’s guest blog comes from María José Lallena, Director, Quantitative Biology. Alcobendas Biochemistry and Cell Biology Laboratory, Lilly Spain and #WeWontRest ambassador.

I work at Lilly’s R&D centre in Alcobendas in Spain with over 100 other scientists. Most of us, including myself, work in oncology. While cancer continues to cause so much suffering and grief, it may seem surprising to say this: but we are on the right track. Today, we know that 83% of survival gains are attributable to new treatments including medicines; for European patients diagnosed in 2012, over 66,000more will live for at least five years after diagnosis compared with if they had been diagnosed a decade earlier. 

But there is so much farther to go, and certainly not for a lack of trying. Our industry invests enormous sums, and my colleagues and I, both at Lilly and elsewhere, are utterly committed to finding a cure. At Spain alone, we invest over €50m annually on R&D, and are running 73 clinical trials with 1,900 patients. But it is such a slow process. The R&D process takes on average 10 to 15 years (from pre-clinical to marketing authorisation) and only 1-2% of every 10,000 substances synthesized in a laboratory will go through all stages of R&D and become an actual medicine.

So how do speed up innovation in oncology? How can we reduce the mortality rate for cancer at a faster rate than we have managed up until now?

I believe the solution lies in the nature of the cures we discover, in particular, narrower targeting and personalisation. And as importantly, in the way key people work together to innovate.

The treatment of cancer has seen an important paradigm shift in recent years. From non-selective cytotoxic drugs which attack tumour cells, but also damage healthy ones and trigger side effects and reduce the quality of life, we are shifting towards new agents that target specific cells whose alternation does not occur in healthy cells. Specific antibodies are an example of this type of treatment. At Alcobendas, my colleagues and I focus much of our research on developing better targeted anti-cancer medicines.

But despite progress in the research, there is still far to go before we acquire a deep enough understanding of the condition in order to beat it. In recent years, great strides have been made by both public bodies, like the Spanish National Cancer Research Centre (CNIO), and private entities like ourselves. We now know that cancer is not a single disease, but many diseases and that each cancer is specific to each patient.

This finding calls for personalised medicine, which I believe represents the future and greatest hope in the fight against cancer. A patient develops a certain type of cancer because some of their genome has been specifically altered. Understanding why this is happening and using this knowledge to stop the cancer is our fundamental goal. But how do we actually get to the point where we can develop personalised medicine? It is a truly formidable challenge. I believe that the key lies in oncology researchers sharing more data - and doing so efficiently - during the early phases of drug development.

But to get to the point where we can offer a specific treatment to an individual patient, we cannot work in siloes. And this gets us to the key success factor I cited above: while private enterprises like Lilly have a lot to offer from an R&D perspective, other bodies are equally essential. Indeed, I believe the perfect ‘triangle’ to address the challenge comprises public research centres (academia), hospitals in which clinical research is carried out, and industry.

And indeed, large public-private alliances exist that combine the experience of public research organizations and the R&D and productive capacities of the pharmaceutical industry.  OncoTrack is one such example. Funded by the EU’s Innovative Medicines Initiative, it is a public-private partnership between the European Commission, hospital centres, and the pharmaceutical industry (including our Alcobendas R&D centre). Its aim is to identify and establish new screening techniques for promising compounds earlier and more effectively, which will be extremely helpful in the practice of oncology. While we still have far to go, these sorts of alliances are no doubt our best bet if we are to win the fight against cancer.

