WIN 2016

Dr Kurzrock meets with ecancertv at WIN 2016 to discuss her role in the conference debate: Is the current design of precision medicine studies the right one? The SHIVA trial, first announced at ECC 2013, compared conventional therapy to personalised therapy based on molecular profiling, with results indicating that precision medicine was no more effective than physicians choice. However, Dr Kurzrock sets out what she considers failures of the trial in design and application, including the introduction of variables beyond administration of personalised medicine, and suboptimal matching of patients to treatment.

Dr Galbraith speaks with ecancertv at WIN 2016 about trial design and application to determine the most well-tolerated and long-lasting combination treatments. She introduces her work with intermittent scheduling of therapies, which has already proven effective in chemotherapy, and how that success transfers to precision medicine. With regard to patient sensitivity to checkpoint inhibitors, Dr Galbraith addresses how novel targets such as DNA damage response pathway are being trialled in staged combinations, and the chances of toxic events arising.

Dr Delaloge meets with ecancertv at WIN 2016 to discuss results from the MINDACT trial. The results, which were first announced by Dr Piccart at AACR, indicate that patient subpopulations who are ranked as 'high risk' by Adjuvant!Online clinical assessment but exhibit low presence of predictive genomic markers could be spared chemotherapy. Dr Delaloge notes the differing survival rates of other subpopulations, and introduces other trial arms of MINDACT whose results will be presented at this year's San Antonio Breast Cancer Symposium.

Prof Schilsky speaks with ecancertv at WIN 2016 about changing understandings of cancer aetiology and treatment. He discusses the growing application of immunotherapy, including checkpoint inhibitors, but cautions against a rush to adopt combination therapy without considering the adaptability and resistance development of tumour cells. Prof Schilsky also comments on the SHIVA trial, as discussed by Dr Kurzrock, and the need for consistent communication and sharing of standards between clinics to advance personalised cancer care.

Dr Vries speaks with ecancertv at WIN 2016 about organoids; personalised stem cell colonies which can sustainably model patient organs and tumours. He details how adult stem cells, marked by LGR5, can be cultured into organoids, and how they can accurately serve as patient analogues. Dr Vries discusses the increasing affordability of organoids, and some clinical successes already reached in treating cystic fibrosis, with cancer treatments currently in research.

Prof Califano meets with ecancertv at WIN 2016 to discuss results from a recent trial in which aberrant protein activity in patient samples was algorithmically linked to disease progression. The algorithm, VIPER, and protein-reporting Oncotarget tests can reveal protein activity linked to cancer without any apparent genomic mutation. Prof Califano describes the potential advantages of pursuing these proteins as targets where is no actionable mutation, with upcoming studies to report on patient outcomes. He also reports on Oncotreat, which is revealing regulation and conservation of DNA master regulators within cancer cells as a possible upstream target of many oncogenes.

Matt Ellefson, founder of patient advocacy group SURVIVEiT, speaks with ecancertv at WIN 2016 about the interplay of patient advocacy and clinical development in cancer care. He describes how online and mobile access to support networks is increasing patient awareness and engagement in their care.

Prof Hood speaks with ecancertv at WIN 2016 about incorporating individual patient genomic and molecular data into their care. By utilising the full breadth of patient data, Prof Hood believes that future cancer care could identify changes in patient genomics to track the course of disease progression, and deliver a personal prognosis on how best to return to health. He goes on to discuss emerging treatments, including the protein peptide capture system being developed by Prof Heath, who spoke with ecancer at AACR 2016, and screening for benign nodules using liquid biopsy. Prof Hood also outlines the theory behind P4 therapy: predictive, preventive, personalised, and participatory therapy that incorporates systems medicine to improve patient outcomes.

Dr Rosenfeld speaks with ecancertv at WIN 2016 about how liquid biopsy samples to derive circulating tumour DNA can aid in surveillance of patient response to treatment. He outlines how circulating DNA can reflect tumour heterogeneity, differences between lesions, and record a patients' changing condition over time. Dr Rosenfeld describes how technology and experience with genomics have enabled many clinics and private companies to derive and interpret the data gained from these samples, and how can go on to improve patient outcomes.

Dr Trusolino speaks with ecancertv at WIN 2016 about novel targets in colorectal cancer. Beginning with the known biomarker of mutant KRAS, Dr Trusolino sets out the process by which suspected driving oncogenes can be identified, isolated in patient samples and tested for sensitivity. These include genes already linked to lung and breast cancer such as EGFR and HER2, which Dr Trusolino details through further resistance studies.

Dr Tabernero speaks with ecancertv at WIN 2016 about the highlights of the WIN symposium. With consideration of novel technologies and patient perspectives, he summarises emerging fields from this years' meeting, and looks forward to future advances.

Dr Meric-Bernstam meets with ecancertv at WIN 2016 to discuss hurdles facing personalised breast cancer therapy. With specific attention to predicting the sensitivity and response of patients to new treatments, she outlines the steps made in identifying common mutations to target, and the benefits of combined adjuvant therapies. Dr Meric-Bernstam describes how these discoveries are also contributing to understanding the biological mechanisms of resistance, and how patient-derived xenografts (PDX) can build a fully personalised model of sensitivity.

Dr de Lorenzo speaks with ecancertv at WIN 2016 about unequal access to advances in cancer care. He outlines the need for wider involvement in regulatory pressures which limit patient engagement, including biobanking of samples, overall healthcare funding and drug approval. With new genomic data becoming increasingly available at lower patient burden, Dr de Lorenzo believes that open communication between patients, clinicians and organisations could lead to cheap, effective, personalised therapy.

Prof Johnson speaks with ecancertv at WIN 2016 about the impact of precision medicine on the diagnoses, management and treatment of lung cancer. From the first inclusion of EGFR in patient profiling to ALK and ABL targeting by modern therapies, Prof Johnson reports on increasing availability and specificity of personalised treatment. He also considers the impact of patient involvement and advocacy, especially in providing biopsy samples which inform future drug design.

Dr Mardis speaks with ecancer at WIN 2016 about widening access to next-generation sequencing as part of clinical practice. She discusses barriers to accessing sequencing data, such as different models of insurance and reimbursement across the world, private companies which offer sequencing services, and determining actionable information from sequencing data. She highlights the value of open-source collaboration among oncologists to share and maximise the usefulness of genomic data, and anticipates its wider use alongside other new technologies.

Prof Leyland-Jones speaks with ecancer at WIN 2016 about the changing field of personalised medicine, from combination therapies to increasing availability of sequencing. He describes the need for investment in screening and upstream healthcare, as time and money spent in preventing cancer can have far-reaching impacts compared to reactive healthcare upon diagnosis. With proteomic, genomic and screening procedures becoming cheaper and more widely available, Prof Jones addresses how personalised therapy is becoming an affordable reality, with specific examples from other speakers at WIN 2016.

Dr Bardelli meets with ecancertv at WIN 2016 to discuss the impact of liquid biopsy sampling on colorectal cancer treatment selection. By tracking the clonal evolution of tumours, he reports successes of genomic targeting for patients with HER2, TRK and ALK mutations, among others, and how samples can closely predict patient response, resistance and relapse. Dr Bardelli considers the evolutionary niche of cancer, and patient wellbeing outcomes as a result of liquid biopsy compared to solid tissue sampling.

Dr Yu speaks with ecancertv at WIN 2016 about regulatory issues and development of precision cancer medicine in Korea. With ASAN Medical Centre being appointed the first Korean next generation sequencing-based clinical testing based laboratory system, Dr Yu considers other obstacles and opportunities in genomics being discussed at WIN.

Dr Goel speaks with ecancertv at WIN 2016 about micro RNAs (miRNAs), and their clinical use as prognostic or diagnostic markers for cancer diagnoses. He reports that RNA fragments isolated from a wide array of sample types can, with thorough assaying, lead to early diagnosis in patients and thus to more effective treatment, especially for those with GI malignancies. Dr Goel discusses how tumour heterogeneity can be monitored and treatments adjusted accordingly, based on miRNA sampling.