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Precision medicine is an innovative approach that involves tailoring treatments to a patient’s individual genetic and molecular make-up, environment and lifestyle. While targeted treatment strategies have been effective for certain cancers, their success has been limited by the heterogeneity and complex genetic changes that underlie many cancers. Cancer drug developers are now exploring ways to further personalize cancer therapies based on the genetics and biology of each tumor and the clinical characteristics of each patient.
Dr. Caroline Heckman and her group at the Institute for Molecular Medicine Finland (FIMM) combine multiomics and functional ex vivo drug sensitivity testing to get a broad view of changes that occur in a tumor, which could be targeted with therapies. In addition, they analyze samples acquired at different stages of the patient’s disease for better insight into disease progression mechanisms, supporting a more personalized approach to cancer therapy.
In this interview, Technology Networks sat down with Heckman to learn more about how precision medicine can be used to help guide clinical decisions for cancer patients and how she envisions the role of precision medicine in cancer therapy evolving over the next few years.
Blake Forman (BF):
Senior Science Writer
Technology Networks
Blake pens and edits breaking news, articles and features on a broad range of scientific topics with a focus on drug discovery and biopharma. He earned an honors degree in chemistry from the University of Surrey. Blake also holds an MSc in chemistry from the University of Southampton. His research project focused on the synthesis of novel fluorescent dyes often used as chemical/bio-sensors and as photosensitizers in photodynamic therapy.
Can you discuss how precision medicine approaches have been used historically in oncology and the challenges these approaches have faced?
Research Director
University of Helsinki
Dr. Caroline Heckman is a research director at the Institute for Molecular Medicine Finland (FIMM) and the University of Helsinki. Her group is focused on understanding pathogenic and drug resistance mechanisms in hematological malignancies. Working closely with the clinic, Heckman’s group applies research tools to patient samples for a better understanding of inter- and intra-disease heterogeneity and translation of basic research findings to patient care. Heckman holds a PhD in oncology and cancer biology from The University of Texas MD Anderson Cancer Center.
Historically, precision medicine has been used in oncology to match certain specific genetic alterations with effective drug treatments. But cancer is a very heterogeneous disease, and this approach is challenged by heterogeneity and the impact that the drug treatments have on that heterogeneity in terms of the evolution of the disease and the changes that occur over time during treatment.
BF:
Senior Science Writer
Technology Networks
Blake pens and edits breaking news, articles and features on a broad range of scientific topics with a focus on drug discovery and biopharma. He earned an honors degree in chemistry from the University of Surrey. Blake also holds an MSc in chemistry from the University of Southampton. His research project focused on the synthesis of novel fluorescent dyes often used as chemical/bio-sensors and as photosensitizers in photodynamic therapy.
Can you discuss how precision medicine can guide clinical decisions for cancer patients with recurring disease who no longer respond to the standard of care?
Research Director
University of Helsinki
Dr. Caroline Heckman is a research director at the Institute for Molecular Medicine Finland (FIMM) and the University of Helsinki. Her group is focused on understanding pathogenic and drug resistance mechanisms in hematological malignancies. Working closely with the clinic, Heckman’s group applies research tools to patient samples for a better understanding of inter- and intra-disease heterogeneity and translation of basic research findings to patient care. Heckman holds a PhD in oncology and cancer biology from The University of Texas MD Anderson Cancer Center.
Functional precision medicine is an excellent platform to approach this challenge, and there you can take advantage of all approved drugs, not just drugs that might be approved for that condition and see if there is anything available that the patients might respond to. And if that drug is available in the pharmacy, then perhaps the treating physician would be able to access that. So, this is a good way to help identify treatments for patients not responding to the standard of care, and it also opens possibilities for drug repositioning.
BF:
Senior Science Writer
Technology Networks
Blake pens and edits breaking news, articles and features on a broad range of scientific topics with a focus on drug discovery and biopharma. He earned an honors degree in chemistry from the University of Surrey. Blake also holds an MSc in chemistry from the University of Southampton. His research project focused on the synthesis of novel fluorescent dyes often used as chemical/bio-sensors and as photosensitizers in photodynamic therapy.
Can you tell us a bit more about the drug-screening approach you have taken to identify personalized treatment strategies for cancer?
CH:
Research Director
University of Helsinki
Dr. Caroline Heckman is a research director at the Institute for Molecular Medicine Finland (FIMM) and the University of Helsinki. Her group is focused on understanding pathogenic and drug resistance mechanisms in hematological malignancies. Working closely with the clinic, Heckman’s group applies research tools to patient samples for a better understanding of inter- and intra-disease heterogeneity and translation of basic research findings to patient care. Heckman holds a PhD in oncology and cancer biology from The University of Texas MD Anderson Cancer Center.
One is that you, of course, need to be able to work with clinicians who could take the information that was generated in the laboratory, in terms of identifying new drugs that might be effective for their patients, and implement that for patients who are no longer responding to the standard of care. But the other way we can use that information is working with pharma companies that might be struggling to identify patients who would respond to the drug that they're trying to develop and help them enrich that population in their clinical studies, so that they can get better results from their trials.
BF:
Senior Science Writer
Technology Networks
Blake pens and edits breaking news, articles and features on a broad range of scientific topics with a focus on drug discovery and biopharma. He earned an honors degree in chemistry from the University of Surrey. Blake also holds an MSc in chemistry from the University of Southampton. His research project focused on the synthesis of novel fluorescent dyes often used as chemical/bio-sensors and as photosensitizers in photodynamic therapy.
How can a precision medicine approach be used in drug repositioning to improve patient outcomes?
CH:
Research Director
University of Helsinki
Dr. Caroline Heckman is a research director at the Institute for Molecular Medicine Finland (FIMM) and the University of Helsinki. Her group is focused on understanding pathogenic and drug resistance mechanisms in hematological malignancies. Working closely with the clinic, Heckman’s group applies research tools to patient samples for a better understanding of inter- and intra-disease heterogeneity and translation of basic research findings to patient care. Heckman holds a PhD in oncology and cancer biology from The University of Texas MD Anderson Cancer Center.
It's a great way to be more sustainable and economical, and creates possibilities to maximize drugs that have already been developed and repurpose them for other patients who might benefit from them.
BF:
Senior Science Writer
Technology Networks
Blake pens and edits breaking news, articles and features on a broad range of scientific topics with a focus on drug discovery and biopharma. He earned an honors degree in chemistry from the University of Surrey. Blake also holds an MSc in chemistry from the University of Southampton. His research project focused on the synthesis of novel fluorescent dyes often used as chemical/bio-sensors and as photosensitizers in photodynamic therapy.
What impact do you envision precision medicine having on personalized treatments of cancer in the next five years?
CH:
Research Director
University of Helsinki
Dr. Caroline Heckman is a research director at the Institute for Molecular Medicine Finland (FIMM) and the University of Helsinki. Her group is focused on understanding pathogenic and drug resistance mechanisms in hematological malignancies. Working closely with the clinic, Heckman’s group applies research tools to patient samples for a better understanding of inter- and intra-disease heterogeneity and translation of basic research findings to patient care. Heckman holds a PhD in oncology and cancer biology from The University of Texas MD Anderson Cancer Center.
Next-generation sequencing (NGS), for example, is now fully accepted and becoming increasingly implementable. Of course, it differs from country to country. What we hope to see in the next five years is the implementation of other technologies, not just NGS. So, looking to see how we can use other multiomic technologies or functional platforms. I think proteomics is easily implementable. Of course, it would be nice to see ex vivo testing, because at least in cancer, we can see that it's highly predictive. But I think we must consider the practicalities in terms of how it can be implemented across different centers.
BF:
Senior Science Writer
Technology Networks
Blake pens and edits breaking news, articles and features on a broad range of scientific topics with a focus on drug discovery and biopharma. He earned an honors degree in chemistry from the University of Surrey. Blake also holds an MSc in chemistry from the University of Southampton. His research project focused on the synthesis of novel fluorescent dyes often used as chemical/bio-sensors and as photosensitizers in photodynamic therapy.
What can industry do to help transition technologies like proteomics from research use to the clinic?
CH:
Research Director
University of Helsinki
Dr. Caroline Heckman is a research director at the Institute for Molecular Medicine Finland (FIMM) and the University of Helsinki. Her group is focused on understanding pathogenic and drug resistance mechanisms in hematological malignancies. Working closely with the clinic, Heckman’s group applies research tools to patient samples for a better understanding of inter- and intra-disease heterogeneity and translation of basic research findings to patient care. Heckman holds a PhD in oncology and cancer biology from The University of Texas MD Anderson Cancer Center.
I think scale it down so it's more focused in terms of what assays can be used. And this is the same way that we move from whole genome sequencing with NGS to targeted panel sequencing. For functional ex vivo drug sensitivity testing, I think this is also a way to move that platform forward and make it clinically implementable. For example, there's no longer a need to screen hundreds of drugs, but we can make more focused panels.
