A Mediaplanet Guide to Creating a More Equitable Future of Cancer Care
Transforming Cancer Care
Chuck D How the Public Enemy rapper is using music to encourage colorectal cancer screenings
How new liquid biopsy technology is improving outcomes in cancer patients Stand Up To Cancer’s new initiative is tackling racial inequity in healthcare
SEPTEMBER 2021 | FUTUREOFPERSONALHEALTH.COM
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Advancing Equitable Cancer Care Through Innovation The saying goes that crisis breeds innovation. One needs to look no further than the COVID-19 pandemic, which continues to upend nearly every aspect of daily life, to know the statement holds true.
ndeed, the global disruption has already sparked remarkable innovation inside and outside of medicine. From record-speed vaccine development to the adoption of virtual workplaces, we’ve been innovating to adapt to our new normal. While the COVID-19 pandemic has laid bare the inequities that exist in our global healthcare systems, it’s also provided us an opportunity to reinvent and test promising approaches to a more equitable future in healthcare. The potential of telemedicine Innovation can bring down barriers to access and make cancer care more equitable, convenient, and efficient for @MEDIAPLANETUSA
patients worldwide. Before the COVID-19 pandemic, telemedicine applications were rarely used in the oncology field. Over the past year, because of the need to minimize interactions and travel, rapid adoption of a broad range of digital healthcare activities and services in the U.S. healthcare system occurred. In fact, research from the American Society of Clinical Oncology found that the use of telemedicine in oncology increased sharply during the pandemic. The potential of telemedicine is very clear: it can allow us to reach people anywhere in the world. Improved patient outcomes Telemedicine’s potential to increase access to care is further @FUTUREOFPERSONALHEALTH
Everett E. Vokes M.D., FASCO, President, American Society of Clinical Oncology strengthened by the possibility that it can be used to improve patient outcomes. We know that survival rates improve dramatically when cancer is diagnosed early. In the most remote parts of the United States and in resource-constrained countries, where there aren’t as many cancer specialists available, providing people with access to diagnostic services such as radiology and pathology can alter the trajectory of the disease
and lead to better outcomes. The use of liquid biopsies and bloodbased biomarkers in screening and diagnosis have gained momentum over the past year. I think, in time, this technology will allow sophisticated algorithms to quickly interpret tissue specimens and perhaps replace genomic evaluations. The pandemic has transformed not only how cancer care is delivered, but also how cancer research is conducted. The pandemic forced many clinical trials to pause for a short time, but with clinical trial enrollment rebounding, the infrastructure responded in-kind with more flexibility as to how the research could be conducted. Simple things like using online platforms
to consent to participation or lengthening the amount of time between doctors’ visits have been shown to be feasible. Oncologists are also monitoring patient symptoms through apps and digital platforms. Real-time reporting by patients means no waiting for a doctor’s visit to have a concern addressed. As we work to fight COVID19 with an eye toward returning to normalcy, let’s not lose the momentum to continue to innovate. Together, as a global cancer care community, we must embrace this opportunity to uncover fresh solutions and make bold bets that fundamentally improve the lives of all touched by cancer, leading us toward a future of equity in cancer care. n
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Publisher Shannon Ruggiero Managing Director Luciana Olson Lead Designer Tif fany Pryor Designer Keziah Makoundou Lead Editor Mina Fanous Copy Editor Taylor Rice Director of Content and Production Jordan Hernandez Cover Photo Travis Shinn All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.
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How Data Ends Cancer Patient Outcome Disparities Not all cancer patients die of cancer. Many die as a result of structural and socioeconomic inequities, a suite of circumstances that cut off access to care and/or insurance and lead to delays in diagnosis and treatment. These delays can lead to unnecessary deaths, especially in non-English speakers or people who are Black, Indigenous, Hispanic/Latino, or LGBTQ+. ne leading c a n c e r research institute is working to fix this — through data. Ending health disparities and easing the burden of cancer are top research priorities at the Fred Hutchinson Cancer Research Center in Seattle. Both its Office of Community Outreach and Engagement (OCOE) and the Hutchinson Institute of Cancer Outcomes Research (HICOR) have amassed a wealth of data on U.S. cancer disparities. • African Americans have the highest overall cancer death rate of any racial or ethnic group in the United States and have for 40 years. • Black women have an almost 40 percent higher risk of dying from breast cancer than white women. • Hispanic people with stomach cancer die at twice the
rate of non-Hispanic people with this cancer. • A merican Indian/Alaska Native people are more likely to get liver, stomach, kidney, lung, colorectal, and breast cancer than white people. • People without insurance are 45 percent more likely to be diagnosed later and to die from their cancer than those with insurance. They’re also less likely to receive standard of care. In a recent Congressional briefing, Dr. Christopher Li, epidemiologist and director of the Office of Diversity, Equity & Inclusion Faculty at Fred Hutch, said, “These disparities date to the very founding of our nation and persist to this day, and they are present along the full cancer continuum — in education about prevention, access to screening, and delivery of lifesaving treatments.” Measures of success — or not His colleague, HICOR director
Dr. Scott Ramsey, knows that you can’t manage what you can’t measure. Ramsey and his team track the challenges and barriers to quality care as a way to improve healthcare practice and patient outcomes. Thanks to this research, patient navigators now help those in treatment deal with language, transportation, childcare, and financial challenges. But it will take policy change, HICOR’s primary goal, to make a true difference. “Social determinants like race, socioeconomic status, and neighborhood have a big impact on cancer patients’ outcomes,” Ramsey said. “Data from our own state show they can impact whether someone is diagnosed at a more advanced stage. And the later the stage, the harder it is to achieve a cure.” One recent HICOR analysis showed people in the poorest neighborhoods were 60 per-
cent more likely to be diagnosed with metastatic cancer, a stage that’s treatable, but not curable. Policy change needed Data drives policy, which is why Hutch researchers continue to drill down into cancer’s disparate numbers, using novel linkages between insurance claims and patient health records to determine where the inequities lie — and how they might be fixed. They aren’t just looking outward, though. They’re also tracking the gaps and gains in diversity and equity within the center’s own faculty and staff and are actively working to recruit scientists, physicians, cancer care, and administrative help from a broad mix of countries, cultures, and ethnicities. In July, the Hutch and its partners — UW Medicine, Seattle Cancer Care Alliance, and Seattle Children’s — announced they’re exploring
a restructure of their longtime relationship. Improving access to pioneering research is just part of why they’re pursuing this change. Health inequities won’t fix themselves. That’s why our scientists continue to shine a light on the country’s disturbing disparities and decry the life-and-death differences — in their clinics, at their lab benches, and through the halls of Congress — to ensure changes in policies and practices that make cancer care equitable for all. n Diane Mapes, Fred Hutch News Service
To learn more about the research behind ending disparities, visit fredhutch.org.
We Must Race to Reduce Disparities in Cancer Research and Treatment When Stand Up To Cancer® (SU2C) invited me to chair their Health Equity Committee in 2018, I was motivated by this new committee’s purpose — to increase patient diversity in cancer clinical trials.
oined by extraordinary committee members with expertise in cancer research and science, we considered how to tackle health equity in the era of precision cancer medicine. Our first goal was to develop the parameters of SU2C’s Health Equity Initiative and establish requirements for SU2C-funded research teams to address recruitment and retention of medically underserved patients in SU2Cfunded cancer clinical trials. Fast forward to January 2020, and we officially announced SU2C’s Health Equity Initiative — unaware that we were on the eve of a global pandemic. As COVID19 took hold of the nation, longstanding healthcare inequities in this country unfortunately came to light as medically underserved Americans, especially Black
Americans, shouldered the burden of the pandemic. Racial cancer care disparities This feels too familiar, as the inequities we’ve seen for decades in cancer outcomes are similarly striking and unacceptable. Cancer clinical trial participation remains lower for minority groups compared to their relative population levels in the United States. According to 2020 data from the FDA, 73 percent of participants are white, 14 percent are Asian, 6 percent are Hispanic, and 5 percent are Black. While American Indian and Alaska Native people, Asian Americans, and Hispanic/Latino Americans experience significant health disparities across many forms of cancer, Black Americans face the highest mortality rate of any racial or ethnic group for most major cancers.
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One cancer that significantly impacts people of color, where we can make significant individual and public health change, is colorectal cancer. Often overlooked or discovered too late, colorectal cancer incidence and deaths rank highest in Black Americans, closely followed by American Indians and Alaska Natives. Disparity in Hispanic adult screening may explain why they too are often diagnosed with later-stage disease, as compared to white adults. Moreover, screening rates during the pandemic dropped significantly and the medical community foresees increased colorectal cancer deaths, and patients presenting with advanced disease. Standing up to cancer SU2C is taking this head-on. By combining cutting-edge research, advocacy group col-
laboration, and awareness campaigns among medically underserved communities, we are sending one clear message: colorectal cancer is in many cases preventable, and screening saves lives. This effort includes funding a dream team of investigators at medical institutions that serve medically underserved communities. By pinpointing local needs and tailored interventions (including free screenings), our dream team will transform participating at-risk communities into “Stand Up To Cancer zones” with high colorectal cancer screening rates. Our goals for screenings align with the National Colorectal Cancer Roundtable (NCCRT) campaign — “80 Percent In Every Community” — to ensure that at least 80 percent of eligible adults are regularly screened for colorectal
cancer. Since this campaign’s launch in 2019, a multi-stakeholder approach has resulted in more than 1,700 organizations focused on a common goal. This is exactly the kind of collaborative and big-picture thinking needed to increase screening and save lives. Speaking of the NCCRT’s work, when we look at the bigger health equity picture in cancer, we know Stand Up To Cancer is not alone. Significant progress, critical conversations, and important collaborations are happening everywhere, bringing together government agencies, advocacy groups, funding organizations, corporations, industry associations, and academic institutions all across the country. I am encouraged by these efforts and appreciate the sense of urgency and focus on this essential work. As we navigate the complexities of healthcare inequity, now exacerbated by the global pandemic, we must keep pushing to increase cancer screening, reduce barriers to clinical trials and quality cancer care, and engage stakeholders, including the research community. We are in this for the long haul; it’s a marathon, and we need a multifaceted approach to reach the finish line. The pandemic may be here longer than we thought, and solving health inequity is an extraordinary challenge for us all. We must remain vigilant in prioritizing access to screening and care for all cancer patients. n Edith A. Perez, M.D., Professor of Medicine, Mayo Clinic; Chair, Stand Up To Cancer Health Equity Committee; Chief Medical Officer, Bolt Biotherapeutics
Addressing Barriers to Clinical Trial Enrollment For millions of Americans diagnosed with cancer this year, their best course of treatment might be through a clinical trial.
linical trials offer patients with difficult-to -treat forms of cancer a chance to receive the most up-to-date and promising care available with the prospects of improved health outcomes and the benefit of advancing medical research. Most patients express a willingness to participate in clinical research, yet only a small fraction ultimately end up enrolling in a trial due to barriers that make participation difficult or even impossible. Consequently, approximately 20 percent of cancer clinical trials fail due to insufficient patient enrollment. Barriers to treatment One of the most common barriers to trial participation is location. Most cancer trials are concentrated at large academic centers that have the resources to dedicate to research, yet most cancer patients receive their care at small, local oncol-
ogy practices. According to a 2018 American Cancer Society Cancer Action Network (ACS CAN) report, Barriers to Patient Enrollment in Therapeutic Clinical Trials for Cancer, only about 1 in 4 patients has access to clinical trials where they are being treated. Yet, if asked to enroll in an available trial, more than half of eligible patients typically agree to do so. Another barrier is cost. While private health insurance as well as Medicaid and Medicare are required to cover the routine medical costs of trial participation, there is no such coverage for other non-medical out-ofpocket expenses patients may incur. Trial participants are often required to see their doctors more frequently, which can mean more money spent on things like gas, parking, food, and lodging. Those costs add up, especially for low-income patients. Research has shown financial burdens can lead to a nearly 30 percent lower trial participation rate among
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individuals with annual family income of less than $50,000. Cancer care inequity Unfortunately, these barriers and others often contribute to long-standing inequities in cancer clinical trials. Despite having an increased burden of disease, racial and ethnic minority groups, older adults, rural residents, and those with lower socioeconomic status are consistently underrepresented in cancer clinical trials. This underrepresentation hampers research and, without deliberate efforts to rectify these disparities, research may miss why cancer outcomes are often worse for patients with limited access to care, lower incomes, and other factors. No one should be disadvantaged in their fight against cancer because of how much money they make, the color of their skin, their sexual orientation, their gender identity, their disability status, or where they live. ACS CAN has
prioritized health equity to ensure that cancer patients are provided with equitable care based on social determinants of health. This is why ACS CAN is working hard to remove these barriers and ensure every patient has equitable access to clinical trials. Reducing disparities In 2018, ACS CAN began analyzing common barriers to patient enrollment and provided stakeholders in the research ecosystem with over 20 recommendations that should be taken to make trial enrollment easier for patients. Earlier this year, ACS CAN issued another report targeted specifically at reducing disparities in clinical trials. Right now, ACS CAN is working to help pass the bipartisan DIVERSE Trials Act through both chambers of Congress. The legislation would help address health equity and disparities by allowing clinical trial sponsors to reimburse patients for non-medical costs associated
with their trial participation — such as travel, parking, food, or lodging — and would allow trial sponsors to provide patients with the technology necessary to facilitate remote participation in clinical trials. The goal of cancer research is to generate new knowledge that can be used to improve survival rates and quality of life for all patients with cancer. But to achieve that goal, it’s crucial that clinical trials reflect the broad diversity of cancer patients they’re hoping to treat. ACS CAN is dedicated to working with patients, survivors, and their loved ones to ensure that happens and to make cancer clinical trials accessible and available to all interested patients. Together, we can improve access and address healthcare disparities for a world with less cancer. n Lisa A. Lacasse, MBA, President, American Cancer Society Cancer Action Network (ACS CAN)
As a member of the rap group Public Enemy, Carlton Ridenhour (aka Chuck D) has never been afraid to take a stand for what he believes in. Now a collaborating artist with Hip Hop Public Health, which has partnered with Stand Up To Cancer, Chuck D is urging everyone 45 and over, and those with a family history of the disease, to get screened for colorectal cancer. With Public Enemy, you made music that brought attention to important political and social issues. What inspired you to start raising awareness about colorectal cancer? We’ve all lost someone, and in a lot of situations there were things that could have been done to keep them healthier and on this Earth longer. Sometimes it’s something as basic as getting check-ups.
I learned from Hip Hop Public Health that Black people tend to get diagnosed with colorectal cancer after it’s already progressed, and that leads to higher death rates — higher than any other racial or ethnic group in the United States. I think a lot of folks don’t know colorectal cancer is beatable 90 percent of the time if it’s detected early. So, it’s a no-brainer to get regular screenings. We just have to get the word out. Can you talk about some of the charity work you’ve been doing to raise awareness of colorectal cancer and encourage people to get screened?
the message they were trying to reach people with. I’ve supported them ever since. Hip Hop Public Health uses hip hop for the betterment of the community instead of it being just commodified to sell songs and products. Their mission is to “deliver positive health behavior change through the transformative power of music, art, and science,” and they’re working with Stand Up To Cancer (SU2C) to get the message out to the community about how much colorectal cancer screenings can change the fate of someone’s life if the cancer is detected early. It’s a huge opportunity. I’m just one small part of the team.
When I first met Dr. Olajide Williams, he told me how much he respected the way I used my public platform and that it could really help spread
Why is it important to encourage all people over 45, but especially people of color, to get screened for colorectal cancer?
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There’s long been distrust with doctors and people in public administration because they’ve ignored us for so long, and as a result there’s a tendency to not go to the doctor. At the same time, there’s an overtrust in the things that we consume blindly that are slowly killing us. So, there’s a lot to overcome, but the work Hip Hop Public Health does is a good way to get in there and change things up. Is there anything you’d like to say to our readers to encourage them to get screened? If you’re 45, or if you’re younger and have a family history of colorectal cancer, get screened. Period. You should get screened even if you don’t have any symptoms. n
PHOTO: TRAVIS SHINN
Believe the Hype: Rapper Chuck D Says Colorectal Cancer Screenings Save Lives
Oncology care is undergoing a transformation many refer to as the precision medicine era. The premise of precision medicine is to provide the right treatment to the right patient at the right time. An emerging precision medicine technology called liquid biopsy holds the promise of improving outcomes for patients with cancer. The term “liquid biopsy” refers to non-invasive approaches that allow analysis and characterization of cancers through blood or other fluids, such as urine, without an invasive biopsy procedure. This has become possible because of biological advances revealing that tumors shed cells and other molecules into our bloodstream and bodily fluids, along with technical advances (molecular biol-
ogy and genomics tools) that enable their detection. Liquid biopsies are beginning to reduce the need for invasive procedures that are used to obtain tumor tissue for traditional biopsies and biomarker data. They have been approved by the FDA as companion diagnostic tests, where they are used to indicate specific treatments for several cancers including ovarian cancer, non-small cell lung cancer, prostate cancer, and breast cancer. Over time, liquid biopsies will be routinely used to help monitor and fine tune treatments and to provide regular screening for individuals at high risk of cancer. Cancer diagnostics during COVID Tragically, the COVID pandemic interrupted cancer
Liquid Biopsy: Changing How We Treat Cancer treatments for many patients. While tissue-based cancer diagnostics decreased during the shutdown, innovative companies embraced mobile phlebotomy so that diagnostics could be brought to the home. As a result, cancer patients were able to receive
the right therapy and care they needed due to the availability of liquid biopsy and other testing outside of healthcare facilities. However, with promise comes the risk that advances will not be available to vulnerable populations,
and health disparities will increase. On the other hand, with the appropriate private-public partnerships and planning, liquid biopsies have great potential to reduce these access disparities. While liquid biopsies are already having an impact
How Clinicians Need to Rethink Cancer Care Treatment Cancer research has evolved in recent years. Scientists now know cancers are driven by mutations in DNA. That led to precision medicine, which uses data to pinpoint what’s driving the cancer. But the United States is falling behind when it comes to adequate research infrastructure for providing cancer care solutions because U.S. labs typically don’t effectively track samples and share data. Until recently, labs have been doing their own data analysis
and keeping the data in-house. Now, a new technology platform is helping scientists and medical providers obtain better results so they can collect and share that data globally, resulting in improved cancer diagnosis and better outcomes for patients. “Having a sense of urgency on something that could impact the world is important to make big things happen,” says Jurgi Camblong, CEO of SOPHiA GENETICS, the company behind the innovative SOPHiA DDM™ platform.
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The cloud-based SaaS platform, which is widely utilized in Europe, hit the market in 2014. Adoption has been quick. They work with more than 780 hospitals and labs in 72 countries. The platform uses AI to analyze patient data and create a tumor profile with a quick turnaround time — tumor information is tracked within days, not weeks. The power of data-driven medicine SOPHiA DDM™ pulls data into a single platform — the
first of its kind. Here’s how it works: a hospital or lab locally sequences a patient’s DNA and then loads that data into the platform. Within hours, the AI annotates and pre-classifies the mutations. In the past, labs wouldn’t have had this accuracy capability, or they’d send the samples to another lab, increasing turnaround time. Currently, SOPHiA completes over 25,000 genomic profiles every month, and are adding additional data layers, including imaging data, to
track how a patient is responding to treatments. This technology can help detect COVID-19 too, including how the coronavirus is evolving, and sharing that data, globally, on the SOPHiA platform. n Kristen Castillo
SOPHiA GENETICS products are for Research Use Only and not for use in diagnostic procedures.
Learn more at sophiagenetics.com
Over the past year, BloodPAC has focused on three main initiatives to address this important challenge: National and global accessibility BloodPAC has established an Accessibility Working Group committed to identifying and addressing key barriers to global access for liquid biopsies, with the goal of minimizing disparities and democratizing their availability.
on treatment decisions, the field of liquid biopsy is young, and there is an opportunity to ensure equal access and to build trust across all at-risk communities. Addressing equitable access BloodPAC is a public-private
consortium supporting the liquid biopsy community that develops standards and best practices, operates a data commons so that data sharing can be used to accelerate liquid biopsy research, and engages all stakeholders to increase accessibility and
availability. With more than 50 members across public, private, and governmental sectors, the not-for-profit BloodPAC Consortium is uniquely positioned to bring the liquid biopsy community together to address equitable access.
Affordability and acceptance BloodPAC has established a Reimbursement Working Group to identify gaps in the current U.S. regulations and reimbursement guidelines. The group is developing standardized evidence-based approaches for the wider
acceptance and use of liquid biopsies. Early detection Finally, BloodPAC has established an Early Detection Working Group addressing specific challenges and opportunities around utilizing blood-based tools for earlier detection of cancer. The group is not only focused on the technologies themselves, but also on how they can be deployed into underserved communities, which often bear a heavier burden of late-stage cancers. This is an unprecedented time in the history of healthcare and cancer care in the United States, and we have a unique chance to capitalize on the variety of disruptions and advances currently underway. n The Blood Profiling Atlas in Cancer (BloodPAC)
Data Sharing: Lessons from the Cancer Moonshot The five-year anniversary of the funding of the Cancer Moonshot is coming up this December. The goal of the coalition was to make a decade’s worth of advances in cancer prevention, diagnosis, and treatment in five years.
ne of the success stories of the Cancer Moonshot is the BloodPAC Consortium, whose mission is to accelerate the development, validation, and accessibility of liquid biopsies to improve the outcomes of cancer patients. The consortium operates the BloodPAC Data Commons to support data sharing among its members and the liquid biopsy development community. Another Cancer Moon-
shot success story is the NCI Genomic Data Commons (GDC), which provides a home for cancer genomics data and is used by over 100,000 researchers each year. Processing cancer genomics data to understand mutations is complex. One of the benefits of hosting your data in the GDC is that all the data is processed uniformly with a common set of bioinformatics pipelines, which significantly simplifies the use of the data by the research community. Both these projects leverage
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data commons for data sharing. Data commons is a software platform for exploring, analyzing, and sharing data in a secure and compliant manner. It is one of the technologies that can make it possible to get done in five years what would normally take 10 years. Other cancer data sharing success stories include: the AACR’s Project GENIE and the ASCO’s CancerLinQ. Both these projects provide large-scale data sharing that has accelerated cancer research.
A long way to go Unfortunately, these success stories don’t tell the whole story, and the lack of robust data sharing is still holding back research discoveries that can benefit patients. Perhaps the most important question that we can ask is: what can change? First, all research funders can require and enforce data sharing and fund data commons and other infrastructure that are necessary to support data sharing. Federally funded research
has taken some important steps in this direction, but philanthropically funded research still has a long way to go. Second, research projects can use data sharing technologies that enable patients to share their data directly. For this to work, healthcare providers must make it easier for patients to share their data using these technologies. Third, we can develop data ecosystems that link together data from different medical research centers and support federated learning. With federated learning, data remains in place and the computation is sent to the data, with the results returned. This way, research data that cannot be shared easily with others due to privacy and other concerns can stay within the security and compliance boundaries of the healthcare provider. Sharing data during the pandemic was bumpy at best. Having a persistent infrastructure in place would provide a good foundation for biomedical research in general, as well as for the type of surge research that is needed in times of crisis, such as a pandemic. n Robert L. Grossman, Frederick H. Rawson Distinguished Service Professor in Medicine and Computer Science, University of Chicago
A Comprehensive Approach to Beating Cancer Around the world, nearly 20 million people are diagnosed with some form of cancer annually — and nearly 10 million die from the disease. One of the biggest factors in the challenge of detecting and treating cancer is the many different forms the disease takes. While the diagnostic tools and treatments available to healthcare professionals are more accurate, effective, and widely available than ever before, there remains much work to be done. QIAGEN, a leading molecular diagnostics and cancer research company, is deploying a comprehensive approach to the diagnosis, analysis, and treatment of cancer that is offering hope for the future. Sample to insight One universal truth about cancer in its many forms is that the earlier — and more accurately — it is detected and analyzed, the better the chance for effective treatment. But the sheer variety of cancer types makes that challenging — there are over 100 different forms of blood cancer alone, for example. Breakthroughs in genetic testing have made it possible to identify and even predict more cancers, but there are many gene mutations to look for, and many testing roadblocks that can delay actionable data.
PHOTO: NAME SURNAME
Cancer is a complex disease with many faces. One company is attacking the problem from all sides.
QIAGEN is leading the way in solid tumors and onco-hematological solutions. Their tools provide an end-to-end solution for multiple results from a single sample and offer panels that provide comprehensive results. These tools allow labs to create patient-specific reports that include diagnostic and prognostic components that help physicians and other healthcare professionals treat the unique individual as effectively as possible. Since cancer is a disease of the genome, QIAGEN has developed diagnostic tools for the analysis of both solid tumors and blood cancers at the genetic level. Their tools detect a wide range of genetic alterations such as BCR-ABL, a fusion found in almost all patients with a type of leukemia called chronic myeloid
leukemia (CML), and KRAS mutations, which are present in 25 percent of NSCLC cases, making KRAS the most frequent oncogene in non-small cell lung cancer (NSCLC). Clinical research Although the tools available to oncologists and laboratories today have advanced incredibly in a very short time, cancer doesn’t stand still. QIAGEN understands that without robust, targeted research, this terrible disease will continue to afflict millions — and that research has led to breakthroughs like its next-generation sequencing (NGS) technology, which can identify mutations across hundreds of genes, and analyze DNA and RNA simultaneously. Combining multiple workflows into one, its multimodal
sequencing process expands the biomarker coverage and maximizes what can be done with limited sample tissue. Tumor growth is another area where QIAGEN’s research tools are making a difference. There are many biomarkers involved in tumor growth and identifying the relevant ones in a specific case is crucial to developing a targeted, personalized approach. QIAGEN understands that not only is every cancer unique, but every lab is unique. QIAGEN works with labs to define genes on a panel as needed, using proprietary technology that provides the analysis of both DNA and RNA. These comprehensive research solutions reduce costs by making it easy to customize panels from limited samples, increasing effectiveness and confidence.
The drive towards precision medicine requires a deeper understanding of the molecular events involved in cancer growth. Cutting-edge research into DNA damage repair pathways has led to QIAGEN’s new homologous recombination repair (HRR) and homologous recombination deficiency (HRD) panels. This makes detecting variants more reliable and assigning HRD scores fast and easy. And the company has leveraged its partnerships with leading pharmaceutical companies to develop companion diagnostic (CDx) solutions for breast and non-small cell lung cancers that can help determine if a patient will respond to a specific targeted therapy, increasing the accuracy and effectiveness of treatment. A future where cancer is more manageable, more easily detected, and more curable is within reach. Achieving that future doesn’t depend on research, improved diagnostic tools, or efficient lab results — it depends on all those things equally. QIAGEN is committed to making improvements in life possible by improving our understanding of cancer, our ability to identify it, and the tools we have to combat this terrible disease. n Jeff Somers
To learn more about QIAGEN’s mission, visit qiagen.com/us/about-us/ our-vision.
The Laboratory’s Role in Transforming Cancer Care
Receiving a cancer diagnosis is scary. It can feel like there is an endless number of unknowns, from the general question of “how bad is it?” to what your treatment and care will look like, to what your life will look like as a survivor.
cancer diagnosis 10 or 20 years ago left a lot of these questions unanswered, but advancements in cancer screening, diagnosis, and treatment have been able to drastically transform unknowns into knowns. The medical laboratory is central to providing those answers. Pathologists and medical laboratory scientists play a unique but essential role in cancer care — we are the ones who run the tests that screen and detect the indicators of cancer. We are the ones who confirm the diagnosis with your primary care physician, who collaborate with your oncologist to establish the
right course of treatment at the right time that is right for you. To ensure patients are receiving the highest quality care, the pathology and medical laboratory science community continually works toward advancing diagnostics in four main areas. Screening You’ve probably heard of molecular diagnostics, or molecular testing, which is the analyzing of the genome for biological markers that may indicate a medical issue. Molecular testing has become an essential part of practice in pathology and laboratory medicine, and in some cases it has paved the way for new screening approaches such
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as for human papillomavirus (HPV) or colon cancer. These advancements are available now, but they’re also paving the way for future screening tests for 20 to 50 different types of cancers using samples of blood or stool, which can mean earlier detection and treatment for patients. Diagnosis Along with molecular testing, genetic sequencing — and direct sequencing of tumor variants — is quickly becoming the standard of care for patients with a new cancer diagnosis. Your tumor variant may mean a different prognosis or a different sensitivity to a potential treatment. These new tests enable us to
diagnose cancer on a more personalized level. Treatment Prognostic testing — performing a test specifically to determine if a patient can receive a certain drug — has been a mainstay in cancer treatment, but in the past five years its use has revolutionized cancer care. Pairing prognostic testing with specific cancer therapies can better target a patient’s tumors and potentially provide a better outcome. Post-treatment surveillance Once a course of cancer treatment is completed, patients continue to be monitored to determine if the treatment was successful. The laboratory
has helped advance this standard of care, using high-sensitivity molecular testing that pushes the boundaries of the limits of detection. This can help determine if the cancer has returned or spread. The technologies used for screening, testing, and treating cancer are evolving rapidly, but the laboratory remains the central core of each new test. The screening, testing, and diagnosing we do as caregivers is essential both for patients and for the transformation of cancer care now and in the future. n Kimberly W. Sanford, M.D., MASCP, MT(ASCP), President, American Society for Clinical Pathology
Croce was noted for his brash style and optimism during his stint as the president of the 76ers, where he brought the team from last place in his first year (1996) to an NBA finals appearance in his final season. Some time after his tenure ended, he went on a lengthy media hiatus, essentially making no public appearances. “I just totally disappeared out of the public eye,” Croce said. “I didn’t do any interviews for almost 20 years.” Then a funny thing happened. In 2020, he developed a sort of rash on his chest. What he initially thought was poison ivy turned out to be T-cell lymphoma. Fortunately, his medical team was able to diagnose and operate on the cancer quickly. Positive mindset Even when confronted with his own mortality, Croce never allowed himself to get upset or feel overwhelmed by the situation. “I never said those words, ‘I have cancer’ — my body has cancer,” he said. “The I that I am — the aware being — has nothing to do with my body.” Still, the health scare changed him and made him want to get back out in the public eye so he could spread his message of positivity and help others in their cancer fights. He tweeted daily messages
Former 76ers President Pat Croce Preaches Positivity While Battling Cancer
PHOTO: AMERICAN CANCER SOCIETY
A lightning rod of personality as the president of the NBA’s Philadelphia 76ers, Pat Croce largely stayed out of the public eye after leaving his post in 2001. A cancer diagnosis, and a partnership with the American Cancer Society, has him bringing his wisdom and positivity to others battling the disease.
of inspiration and positivity, but it wasn’t enough; he wanted to do more. “I wish I could affect more people. People don’t have to suffer,” Croce said. “Buddha said pain is inevitable, suffering is optional. Now that’s 2,500 years ago, but it’s as true today as it was then.” He got in touch with Paula
Green, vice president of development for the American Cancer Society in Philadelphia, and asked what he could do to help others living with cancer. “She goes ‘Pat, we have this program called HEALED — Health and Energy through Active Living Every Day,’” Croce said.
The HEALED movement HEALED is a movement designed to help people live healthier and more active lives while raising critical funds for cancer research. Seventy-five percent of people diagnosed with cancer are less active than they were before their diagnosis, according to research from Memorial
Sloan Kettering. That’s a major problem, because being physically active can reduce cancer risk, improve quality of life, and minimize the physical and psychological effects of a diagnosis. “Every day you’re alive, you should be doing something,” Croce said. “It doesn’t matter what you do; enhance the quality and the quantity of your life.” Since joining the movement, Croce has been hosting weekly virtual gatherings featuring guest experts and cancer survivors. They cover topics related to physical, mental, and spiritual health, and they’ve included Philadelphia sports icons like former Phillies third baseman and baseball Hall of Famer Mike Schmidt (a melanoma survivor), as well as former Philadelphia Inquirer columnist and current ESPN personality Stephen A. Smith (whose mother died in 2017 after a battle with colon cancer). Since launching the movement earlier this year, Croce has helped HEALED raise over $2 million, all of which goes toward funding innovative science on healthy living, cancer risk reduction, and survivorship. If you make a donation of any size, you’ll receive a black lava bead bracelet with one green bead, which, as Croce says, signifies that we’re all in this fight together. “You have an entire divine universe with you, behind you, and this one green bead signifies that it’s more than just you,” he said. “We can all handle it together.” To learn more or donate, visit ACSHEALED.com. n Dustin Brennan