Unlock the Future of Cancer Treatment: Targeted Therapies from a European Perspective

The Paradigm Shift in Cancer Diagnostics

Advanced molecular diagnostics are fundamentally transforming patient outcomes. Historically, diagnosis and treatment relied on the location and stage of the tumour. Now, increasingly sophisticated approaches allow healthcare professionals to understand cancer in much greater depth, enabling the selection of personalized treatments that target specific biological pathways. This detailed understanding can improve effectiveness and reduce the chance of severe side effects.

Key Topics Explored in the Episode:

• BRCA Mutation Testing: The medical benefit of knowing BRCA status has increased steadily since its discovery 30 years ago. Professor Pujol discusses how BRCA mutations, which affect about one in 200 individuals, are vital not only for prevention but also for personalized treatments using PARP inhibitors across breast, ovarian, prostate, and pancreas cancers. ASCO guidelines now propose testing any woman with breast cancer under 65, any man with breast cancer, and every woman with ovarian cancer.¹

• Tissue-Agnostic Therapies and Trial Design: Progress in defining molecular alterations shows that frequent or rare alterations (like gene fusions or MSI) can be present across cancers regardless of their site of origin. This requires researchers to think beyond the primary tumour site. The podcast delves into novel clinical trial designs, such as basket trials and synthetic control arms, developed to rapidly test genetic mutation-drug matches across multiple cancer types.

• Biomarkers in Immunotherapy: We explore the role of Micro Satellite Instability (MSI) as a predictive biomarker for sensitivity to immunotherapies. While the FDA granted immune checkpoint inhibitor the first tissue agnostic approval for MSI-high/dMMR solid tumours, the pan-European (EMA) and national regulatory landscapes show variation in approval and access.²

• The Power of NGS and Liquid Biopsies: Next-Generation Sequencing (NGS) is considered the standard of care for lung cancer, where over 10 alterations are targetable. NGS is widely seen as more cost-effective than sequential testing methods. Furthermore, liquid biopsies are becoming a highly promising tool for monitoring resistance, identifying minimal residual disease, and even moving towards early detection and screening.

Addressing European Disparities

Despite these incredible medical advances, complex regulatory and reimbursement pathways in European countries are slowing the availability of new technologies and contributing to inequalities in cancer outcomes. The discussion highlights the urgent need for policymakers to act in five key priority areas to ensure health systems are ready to adopt advanced diagnostics and achieve better testing and better treatment for all people with cancer.

Listen Now!

Ready to learn how we can move from under-considering diagnostics to making them a priority? Download the full episode, "Targeted therapies in cancer: From clinic to labs" to hear the full discussion on these vital issues.

1. Isabelle Bedrosian et al. Germline Testing in Patients With Breast Cancer: ASCO–Society of Surgical Oncology Guideline. J Clin Oncol 42, 584-604(2024).
2. Casak SJ, Marcus L, Fashoyin-Aje L, Mushti SL, Cheng J, Shen YL, Pierce WF, Her L, Goldberg KB, Theoret MR, Kluetz PG, Pazdur R, Lemery SJ. FDA Approval Summary: Pembrolizumab for the First-line Treatment of Patients with MSI-H/dMMR Advanced Unresectable or Metastatic Colorectal Carcinoma. Clin Cancer Res. 2021 Sep 1;27(17):4680-4684.