From innovation to improved patient care: challenges for foundations and cancer research organisations
Dr Jacques Raynaud - Association pour la recherche sur le cancer (ARC), Villejuif, France
The lecture I will give this afternoon is related to challenges for transforming innovation into real therapeutic innovation for the benefit of patients. It’s all about what WIN is and we will be at the end of all the lectures we have heard and we can gather all the potential hope that results offer today. But to transform this into real impact for the patients we need to alleviate many hurdles and we are facing many challenges of different categories.
What are some of the challenges that are being faced?
There are at least three categories of challenges. The first one is scientific and medical, the number two category is more societal and the number three is finance, of course. So let’s come back and say the key points of each of them. The first one, scientific, there are many new, thanks to new technology, data approaches, ways to characterise the cancer disease by what we call omics – genomics, transcriptomics, proteomics and now immunology. The techniques have to be precise and harmonise all over the world so we can speak the same language and we can compare trials, their results and try to conclude what is the best. We have also to build new ways for protocol design; we cannot do the same things as ten years ago, things have changed. We have to also face the heterogeneity of tumours, the role of microenvironment. There is a lot of benchwork and preclinical work to predict what will be the response and what would be the best combination. So we understand that science, technology and medicine are together representing many data, many obstacles, to fight against them.
Can you tell us more about the societal challenges?
Societal, I would say that there are some; one of the first is the mobilisation of patients and professionals. Now things have changed dramatically, significantly, and the first challenge is to inform and educate all the stakeholders in our society. Another part of this group of challenges is related to regulatory matters where countries, because they are also health payers and health authorities, and today worldwide we do not have the same approach, the same possibility to reimburse, to set prices. So this is a real society question.
What about the financial challenges?
Finance is a simple question because without resources what can we do, even if we have the best ideas? For example, it starts with our non-profit organisation because as we are a charity organisation we exclusively depend upon our donors and philanthropy. To be clear, there is even in that field a huge competition because there are so many needs, not only medical, in society that we have to make sure that we have the appropriate resources. And the other financial part related to the cost of all these evolutions in technology. Once a researcher acquires an equipment in very few months another equipment is needed which improves the technology. Also it’s obvious, and everyone knows this, the cost of drugs where we had an exponential increase in the cost of drugs. This is a real obstacle.
How can organisations such as the ‘Fondation ARC pour la recherché sur le cancer’ address these challenges and help move precision medicine forward?
In front of this amount of difficulties and so many numbers, we have to focus our efforts, we cannot do everything. Personalised precision medicine is one of our focuses. And to transform the knowledge from fundamental into new therapeutics, we have focussed our effort on the early clinical phase. It’s exactly what does WIN. In fact, we have made choices because with limited resources you need to make choices and to take risks, because when you do something you cannot do the other thing. So choice, decisions, but we have to take those risks because patients are waiting on us. We tell them that research has a lot of results so they are waiting and they have confidence in the results and in the health professions. So the more we tell them we have improvement the more they are willing and excited too. We understand why because it’s their life and the quality of life. This we have to answer to them.
Are there any other points we ought to consider?
There are so many stakeholders with conflicting interests: a patient’s interest is life, quality of life; a company, industry or technology is and can be profit; a researcher can be simply a publication for their career. And we have to bring together all these stakeholders to converge towards… they have the same goal but the same pathway to rapidly, because there is a need of urgency, patients are waiting to rapidly come to solutions.
