Earlier this week, Stephane Budel wrote an article about the role diagnostic technologies will play in the future of precision medicine. Stephane is a founding partner at DeciBio, a leading research tools and diagnostics market intelligence consulting company.
Cancer therapies have largely been the focus of research and praise within the oncology space, with immunotherapies and checkpoint inhibitors claiming much of the limelight. However, these therapies are often administered in the later stages of disease progression and are far from a cure for cancer, but a life-prolonging treatment when used with other therapies.
With that said, what will it take to win the war against cancer and improve precision healthcare at large?
According to Budel the answer is diagnostic technologies.
Currently, diagnostic tests are priced based upon how much they cost rather than their value, despite their increasing impact on aiding medical decision making. This discrepancy has stifled innovation Budel explains, as he goes on to highlight three examples of how the use of diagnostics can transform the clinical outcomes based upon where they are used in the patient journey.
During the patient journey there are three ways in which diagnostics can play a crucial role: early cancer detection, improved therapy selection and longitudinal monitoring.
Patient prognosis is generally based on the cancer stage at the point of diagnosis. Using the example of lung cancer, only 5% of patients will survive five years after diagnosis if it is detected at stage 4 after metastasis, compared to an over 60% survival rate when detected at stage 1.
Many companies are now working on developing technologies that can detect cancer in the earliest stages using a minimally invasive blood test, a liquid biopsy. In the long run, a pan-cancer test will prove to be a holy grail to the oncology community, a single test that can detect multiple cancer types. By the end of this decade, Budel predicts that early detection diagnostics will have a bigger impact on cancer survival rates than therapies.
Inevitably, some patients will continue to progress into late-stage disease, where diagnostic tests could be used to improve the therapy selection. Using next-generation sequencing, diagnostic tests can assess the uniqueness of a person’s cancer and enable clinicians to select the best drug combination.
And finally, for patients who have undergone treatment, precision diagnostics can enable longitudinal monitoring for minimal residual disease. Minimal residual disease (MRD) is a term used to describe a small number of cancer cells in the body after treatment. Currently, patients are primarily monitored for recurrence using imaging technologies. MRD monitoring has been shown to detect recurrence months before they are visible on a CT scan, and starting therapeutic intervention earlier could be lifesaving.
Likewise, diagnostics may be the key to precision medicine in other therapeutic areas. For example, wearable sensors are allowing for remote patient monitoring that can help to detect early-onset or progression of neurodegenerative diseases such as Alzheimer’s or Parkinson’s. The same applies to cardiac disease, with the Apple smart being able to detect atrial fibrillation.
Budel concluded that soon “precision medicine” will simply be known as “medicine” and diagnostics will play a pivotal role in the revolution and help improve overall healthcare spending.