| Sponsor content by GENENTECH, A MEMBER OF THE ROCHE GROUP Four questions with a leading mind in cancer care In June 2022, Dr. Levi Garraway, chief medical officer, executive vice president and head of Global Product Development at Genentech, sat down with STAT at an event at the annual meeting of the American Society of Clinical Oncology. Dr. Garraway offered his perspective on some of the most exciting things happening in cancer research and his hopes for what's next. Read his response to four questions asked on stage. This interview has been edited for length and clarity. It feels like a really exciting time in oncology. What are you most excited about? What's great about being in this field is there are many things to be excited about. If I had to name just a few, the first would be newer modalities to harness the immune system. Bispecific antibodies, for instance, medicines that can bring T cells to tumor cells. We've seen how these medicines could help redefine certain standards of care in benign hematology, and now we're aiming to transform how we treat different types of non-Hodgkin's lymphoma. The second thing, I would say, is the ability to detect cancers earlier. We think a lot about moving treatments earlier in cancer. Some of the next generation blood-based approaches to detect cancer earlier may potentially identify more patients at curative stages. They also may enable different kinds of intervention studies going forward. Targeting earlier is about more than just medicines. In certain cancers, people can benefit from early treatment if we can catch it earlier. So timely cancer screening becomes more important than ever. The third thing that comes to mind is newer kinds of targeted therapies for extending the paradigm of precision oncology. Of course the importance of comprehensive genomic profiling is still there, but moving into other kinds of molecular profiling. Right now, we're seeing newer targeted agents and the ability to impact targets and pathways that for a long time were very difficult. This is an important and emerging area because the more we understand about an individual's cancer type, the better treatment decisions we can make for them. We're seeing more of this thinking being integrated into novel clinical trial designs such as adaptive, platform, basket studies where we leverage precision oncology to speed up drug development because we are testing new therapeutic ideas more effectively and efficiently. Not all progress is easy though, right? It has been much tougher to identify new targets in immunotherapy. That is true. With immunotherapy, and any new kind of paradigm, it leads to a lot of research; some of which may end up being disappointing, but from that there are still learnings that take us forward. So part of the challenge and part of the fun in this field is to keep a broad view, go where the science tells us – taking smart risks and acting on what we learn from every result. What's your greatest hope for the industry over the next five years? I'm hoping there will be another paradigm that tells us how we do better with the many patients who don't respond adequately to therapies. There are whole cancer types where neither targeted therapy nor immunotherapy has really moved the needle. What are the paradigms that are going to break new ground, so we can offer new kinds of advances to people who just haven't benefited? That would be one big hope, to see the next big paradigm shift in treatment. Another one would be addressing the issue of inequitable access to care. To start, we need to think outside the box about how we can have a different outcome with inclusivity in clinical trials. We need to think differently about sites, credentialing sites, and where you go to enroll sites. During the pandemic, we had a study where the expressed intention was to enroll exclusively underserved patients. It was a little more difficult in the beginning, but it was doable. The quality of the study and its impact was every bit what you would hope for with any other study. We know it can be done, but it's not easy. As an industry, we've started making progress, but we have much longer to go. If someone is making the transition from peer research into drug development now, what would your best piece of advice be? There's a misconception that when you make the leap from academia to industry R&D, that you're leaving the science behind, you're leaving the rigor. I would say nothing could be farther from the truth. I would venture to argue that the importance of bringing a detailed understanding of disease biology into the clinical development world is critical. If you're in a basic science environment and you think maybe someday you could transition to pharma R&D, I encourage you to master your craft as a scientist. You are going to need it. Watch the full discussion below, and learn more about Genentech by visiting its Oncology Hub. | 
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