Day One of the World Medical Innovation Forum began with a wave of young investigators highlighting promising developments in cancer research in a series of rapid-fire presentations. Recurring themes of the First Look session included the use of RNA in-situ hybridization (RNA-ISH) as a diagnostic tool, liquid biopsies for exosome analysis, and precision medicine approaches to patient care. Multiple presentations also highlighted the capabilities of the AMIGO suite at Brigham and Women’s Hospital, which uses intraoperative imaging to guide precise localization and analysis of patient tumors during surgery.
Attendees then had the chance to liaise with established Harvard Medical School faculty over lunch during the Discovery Café session, which paired interested Forum-goers with renowned leaders in their respective fields. Nearly 30 faculty members covered topics such as immunotherapy, diagnostics, therapy resistance, and the potential of CRISPR for research and therapeutics.
The Forum plenary opened with David Torchiana, MD, CEO and Anne Klibanski MD, Chief Academic Officer of Partners HealthCare, who welcomed an audience representing more than two dozen countries and introduced a program filled with high-caliber speakers and hot topics including immunotherapy, epigenetics, and bioinformatics. They emphasized the importance of collaboration to accomplish the goal of providing better care and support to cancer patients and their families and noted that the “engine of innovation is running better than ever” as we seek to push the boundaries of the many diseases collectively known as cancer.
After a series of thought-provoking sessions, Astellas Pharma announced the launch of the inaugural C3 Prize™. The day culminated with inspiring remarks from Greg Simon, Executive Director, The White House Moonshot Initiative and a fireside chat with Richard Gonzalez, CEO of AbbVie (stay tuned for more about the Forum’s fireside chats in tomorrow’s Day Two recap). For more in-depth highlights from some of the most interesting panels from Day One, see below.
A War or Moonshot: Where Do We Stand?
In the first panel of the day, Nancy Snyderman, MD, Medical Advisor at GE Healthymagination, sat down with Monica Bertagnolli, MD, Chief of the Division of Surgical Oncology at Brigham and Women’s Hospital, and Daniel Haber, MD, PhD, Director of the MGH Cancer Center to discuss what’s to come in a new era of cancer research and care. The panelists were tasked with advising on whether cancer research and care over the next decade will be a war or a moonshot. Panelists agreed on both perspectives – a war because, from a patient perspective, it is a personal battle against disease and we must come together as an army to combat the disease and work effectively towards a cure, and a moonshot because progress in cancer happens with huge steps forward and reflects the combined efforts of a large group of people working toward a common goal, much like landing on the moon.
When asked about the funding landscape and future of academic research and development in oncology, Dr. Bertagnolli noted that, when money is tight, teamwork must be utilized, and support from patient organizations such as Stand Up To Cancer is profound. Dr. Haber also noted that we are at a magic time during which so much science is being translated, but that funds are also needed for basic research, with the rationale that, if all money goes to translational research and we do not value basic discovery, then there will be nothing to translate in the coming years.
Creating a Disruptive Cancer Pipeline and Winning Portfolio Strategy
A focus of Day One included cancer pipeline and portfolio development, which began with a panel discussion of how to build and maintain a successful pipeline in a challenging environment. Panelists including Keith Flaherty, MD, Director of Clinical Research at the MGH Cancer Center, and Sean Harper, MD, Executive Vice President of Research and Development at Amgen, commenting on company culture and regulatory oversight of clinical trials.
Jay Bradner, MD, President of the Novartis Institutes for BioMedical Research, noted that we may not be able to visualize what a cure for cancer will look like at this time, as technologies are still emerging, but that we should beware of paradigms, as they can sometimes make you blind to the next breaking wave.
In a discussion of clinical trial participation, panelists stressed the need for improved navigation of study information for patients, which would in turn facilitate the interactions between these patients and their physicians and potentially improve recruitment. It was also noted that these patients should have access to expert opinion on the best trials for their disease; as George Demetri, MD, Director of the Center for Sarcoma and Bone Oncology at Dana-Farber Cancer Institute noted, it should not be so much easier to find the best Chinese restaurants on “Dr. Google” than it is to find the best clinical trial.
Panelists discussed the need for improved infrastructure that would hasten the timeline from ideas to clinical trials and noted that the FDA is responsive to novel approaches and is looking to industry and academia for advice. Dr. Demetri also noted that such an idea is on the table, with the proposed creation of an Oncology Center of Excellence at the FDA.
Overall, panelists indicated that the pharmaceutical industry is receptive to insight from academia, and that the field appears to be aligned in the early drug discovery mission. In a discussion of the interactions between small companies and big pharma, panelists noted that the small companies tend to be very innovative, but investments are risky. Sean Harper, MD, noted that pharma tends to be very open to bringing assets in to their pipeline, but would rather engage early on to ensure that it’s a good product, and that takes engineering.
Curative Therapies: The Economics of Game-Changing Science
As novel, potentially curative cancer therapies come to market, drug pricing has emerged as one of the hottest topics of discussion. Speakers shared their insights on the balance between affordability and continued innovation in the healthcare industry, which was emphasized by Betsy Nabel, MD, with the notion that we need to provide the “right treatment for the right patients at the right time” while making it affordable.
Speakers included Troy Brennan, MD, Executive Vice President and CMO of CVS Health, Paul Hudson, President of AstraZeneca US, Betsy Nabel, MD, President of Brigham and Women’s Hospital, Gary Reedy, CEO of the American Cancer Society, and Peter Slavin, MD, President of Massachusetts General Hospital. The panel was moderated by Sue Siegel, CEO of GE Healthymagination.
In the session, panelists discussed how to measure the effectiveness of a treatment. Dr. Slavin noted that we are facing much more economic pressure in healthcare and that it is critical to eliminate care that doesn’t help our patients. Panelists suggested that the private sector, including commercial payers, academic medical centers, pharmaceutical industry, biotech, venture, and pharmacy should come together to determine the value framework, rather than leaving it to CMS.
Mr. Hudson noted an inherent risk associated with developing medicines, and that the demand for breakthroughs and targeting of smaller patient populations has never been higher, while Dr. Nabel reminded us that companies must also consider the costs associated with innovation, as well as the hidden cost for future development if innovation is left behind. Panelists suggested that pharmaceutical companies, insurance providers, and pharmacy benefit management companies should come together to share risk, as all parties would be incentivized if the risk is broadly distributed.
When asked about when cancer will become a chronic disease, a majority of the panel agreed that it would be within 10 years, while one panelist noted that, in some patient populations, the time is now.