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Business & Regulation Business Practice, Drug Discovery

Many Hands Make Light Work

When I started my career in pharma 15 years ago, lung cancer was a fatal disease. Most patients (around 85 percent) were diagnosed at stage IV. This meant that the disease was no longer limited to the lungs, but had spread throughout the body. With limited treatment options, life expectancy was approximately 12 months. The seriousness of the condition also led many patients to believe that testing and treatment were futile. Today, we have a better understanding of cancer biology. Now, more patients are diagnosed early, before the disease has spread. The introduction of personalized medicine is also transforming patient
outcomes.

Despite these improvements, the five-year survival rate for lung cancer remains among the lowest of all cancer types. Last year, more than 140,000 people in the US alone died from the disease, representing nearly 25 percent of all US cancer-related deaths (1) And although precision medicine and biomarker testing have been important, their adoption isn’t widespread. Universal biomarker testing, for example, is not yet the standard of care. Recent data indicates that only 7 percent of non-small cell lung cancer patients receiving care in community oncology practices received comprehensive testing for all biomarkers recommended in the National Comprehensive Cancer Network guidelines (2). We must ensure that all eligible patients receive appropriate testing and that oncology providers know to collect samples for all patients – even those with early-stage disease.

As part of its Major Pathologic Response Project, the Lung Ambition Alliance is validating surrogate endpoints to accelerate drug approval in early settings. We are also using our understanding of the molecular features of cancer to identify patients at high risk of early relapse and those who may benefit most from therapeutic intervention. As we make strides in developing new diagnostic tests and targeted therapies, provider education is essential to ensure eligible patients receive timely testing and treatment.

Ultimately, no progress is possible alone. In my opinion, collaboration and the ability to ensure that medicines get to patients at the right time are crucial factors in our continued progress. Through partnership, we can better understand all aspects of the patient journey, hear the patient’s voice, and holistically address cancer care and treatment disparities. And companies across the industry are beginning to respond to our call to engage in this important battle. The Lung Ambition Alliance, which is led by AstraZeneca, the Global Lung Cancer Coalition, the International Association for the Study of Lung Cancer, and Guardant Health, recently announced that five companies would join on as project partners (Bristol Myers Squibb, Eli Lilly and Company, Genentech, Merck, and Novartis). (A strong collaboration like this will help bring treatments to patients faster – but is it enough to realize a future without lung cancer?

Though I cannot accurately predict this, I can share my aspirations. Lung cancer is not one single disease; rather, it is multiple. If we can develop targeted therapies for each of them and ensure that patients enjoy the best quality of life during treatment, then, in my view, we will have made considerable progress. I want us to work together to redefine the treatment landscape and, one day, eliminate lung cancer as a cause of death.

When it comes to facing lung cancer, there is more hope than ever. From the potential to screen and diagnose early to treatment options tailored for each patient to holistic quality care – we’ve already seen important advances. But we can’t stop now. My mantra is, “No rest until no lung cancer!”

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  1. American Cancer Society, “Key Statistics for Lung Cancer” (2020) Available at https://bit.ly/2ZsiwGE.
  2. HJ Gierman et al., “Genomic testing and treatment landscape in patients with advanced non-small cell lung cancer (aNSCLC) using real-world data from community oncology practices,” J. Clin. Oncol., 37, 1585 (2019).
About the Author
Camille Hertzka

Head of US Medical Affairs at AstraZeneca, a founding member of the Lung Ambition Alliance, Gaithersburg, MD

Head of US Medical Affairs at AstraZeneca, a founding member of the
Lung Ambition Alliance, Gaithersburg, MD

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