Humans are now living longer than ever, and the natural lifespan is only expected to increase into the future. Cancer will become a growing threat to public health systems worldwide, and there is an urgent need for effective treatment solutions. As a global pioneer in oncology, Agilent Technologies uses companion diagnostics to identify which patients stand to benefit most from specific cancer treatments.
Approximately 38,000 Danes are diagnosed with cancer each year. While chemotherapy remains the most common treatment, only 25 per cent of cancer patients respond to it.
Given that it is broad-spectrum, chemotherapy damages not only cancer cells but also the body’s healthy cells. Its most common side-effects are hair loss, nausea, and mucosal problems. Moreover, a treatment process without clear benefits can be mentally degrading to a patient, just as it costs the state approximately 300,000 Danish kroner per patient annually. Ultimately, 75 per cent of the treatments are both harmful to patients and expensive to the state.
Better diagnostics are needed to ensure precision treatments and improved outcomes for individual patients and the system.
According to Simon Østergaard, Vice President of the global Pathology business and CEO of Agilent Technologies Denmark, “It is critical to identify the patient’s specific type of cancer as this increases the likelihood of treating the right patients successfully. That is why companion diagnostics are key to identifying who can benefit from a given treatment. With the help of targeted diagnostics on tissue samples, we can assess whether or not the individual patient benefits from specific cancer treatment.”
We have been at the forefront of developing diagnostic kits and establishing collaborations with most of the largest pharma companies in the field of oncology
In 2012, Agilent Technologies acquired Dako Denmark A/S, which was the first company worldwide to begin to conduct tissue diagnostics to the identification of the body proteins via tissue staining. In 1998, Dako launched HercepTestTM, the world’s first companion diagnostic kit to identify HER2 breast cancer patients. More recently, in 2016, Agilent Technologies launched the companion diagnostic PD-L1 kit a tool for oncologists and pathologists to identify targeted treatments for patients with specific types of lung cancer who can then be treated with Keytruda® (pembrolizumab) from Merck & Co.
As a genetic disease, one cannot cure cancer without understanding the complicated relationships between the multiple genes and proteins that control the cell cycle and which, through random mutations, can lead to malignant cancerous tissue.
As the research and development manager at Agilent Technologies, Signe Bagge Nielsen explains: “We are assessing whether the specific patient holds immune cells that can be used in cancer treatment. We do this through tissue diagnostics and biomarkers because we know from clinical studies which patient profiles can benefit from the medicine. From tissue sections, pathologists can assess whether each patient will respond to treatment.”
Over the past 7 years, Agilent Technologies has made great strides in building on Dako’s pioneering spirit, leading to the establishment of several collaborations throughout the pharma industry worldwide.
In Østergaard’s words: “We were the first to demonstrate the link between treatment and diagnostics. We have been at the forefront of developing diagnostic kits and establishing collaborations with most of the largest pharma companies in the field of oncology. Innovation in the industry is characterised by those who are skilled at collaborating with the pharma industry, and those who have staining solutions and instruments placed in the pathology laboratories worldwide – and, in this domain, we have been a leader.”
The number of people living with cancer has increased significantly over the past 50 years, primarily because humans are living longer and cancer is most prevalent among those who are aged 65+.
Agilent’s methods are particularly useful in diagnosing for example lung and breast cancer. Within the foreseeable future, Østergaard expects that the group will be able to diagnose even more types of cancers: “The regulatory landscape is putting pressure on the industry as a result of the increasing need for targeted treatment; hence more cancer patients are expected to benefit from our diagnostics and the corresponding cancer medicine. The more indications we can include on our labels, the more people will benefit.”
He credits collaborations with the pharma industry as increasing the impact of their work and reducing the large number of people who have gone through chemo courses in vain.
Evolving from a small company on a global scale, which offered a wide range of antibodies and routine diagnostics, to now also being the world leader in companion diagnostics creates value for all stakeholders: “In the future, we can help even more people with this awful disease. We are doing something good, and we are shaping an industry,” Signe Bagge Nielsen explains.
According to Simon Østergaard, companies must prove that they can link cancer medicine to the companion diagnostics as a matter of regulatory pressure. In other words, every drug company that supplies cancer drugs must have a biomarker strategy for each drug.
Expanding on this point, Østergaard claims: “Twenty years ago it was not possible to sequence DNA of individuals. Today solutions are developed with fast pace to the point where it starts becoming a commodity, and it will also impact cancer diagnosis gradually over time as its clinical utility is getting adopted in clinical settings at the hospitals.”
Digital solutions overcome a lack of resources
Within years, the industry will likely see a shortage in the number of pathologists, so we must think differently in planning for the inevitable future, which can also help pathologists generate accurate and consistent diagnostic results.
According to Østergaard, “We, like the entire industry, need to figure out a solution to bridge the competencies gap that will arise. We are looking at the opportunities that digital pathology can provide as a supplement to the shortage of pathologists. For this, we are investigating how we can translate tissue assessments into a diagnosis and how we can apply algorithms as part of the process. More broadly, there is no doubt that the Internet of Things is appealing when you have a large installed base of instruments that can be serviced and monitored in the event of a crash. Remote services are particularly interesting.”
Overall, this industry is on the rise – armed with data and algorithms. For their part, Agilent Technologies is working to prepare for the digital transformation under the concept of ‘digital pathology’. Østergaard suggests this is a global trend in the industry and is encouraged by the competent colleagues he has in Copenhagen, Carpinteria, Santa Clara and Tel Aviv. Of course, it is easy to be overwhelmed by new data, new technology, new methods, and new goals, let alone new social paradigms. It is a challenge not only for oncologists and pathologists, but also researchers, developers, and marketing new targeted cancer therapies.
Having the last word on the matter: “We are looking for a wide range of profiles within business, science and technology to develop our global biotechnology business, but it will also be important that we have the right skills on board to build new digital solutions,” Østergaard explains.