Increased understanding of underlying disease biology, an evolving clinical trial landscape, and a proliferation of analytic tools and real-world data have made oncology one of medicine’s most rapidly advancing areas. But as calls for faster innovation continue to grow, the global biopharmaceutical industry is considering new ways of working, collaborating, and focusing on health equity to help more people living with cancer.

Levi Garraway, chief medical officer and head of product development at Genentech, has dedicated his career to “bridging the chasms” in R&D in order to accelerate life-saving treatments for those that need them most. Since joining Genentech in late 2019, Garraway has focused on five key areas that are shaping next-generation treatments for cancer, and the future of R&D.

Moving forward by looking back
Garraway says looking closely at past successes may help fuel new breakthroughs. He believes that by building on fundamental insights from successful treatments such as immunotherapies and targeted therapies, companies like Genentech can unlock new ways of identifying novel disease targets. However, it’s equally important to glean insights from cases where things didn’t go well. In order to continue changing the outlook of devastating diseases like cancer, Levi says, “what we are doing now is leveraging our scientific understanding and broad portfolio to build out rational (medicine) combinations that could yield substantial advances in tackling diseases. We also need to learn from past failures to set us up for future successes. We’re not going for incremental treatments. We’re targeting breakthroughs wherever we can.”

Innovating without borders
Garraway also believes collaboration across the healthcare community is essential to tackling these challenges. Joining forces with other companies and researchers will yield a deeper understanding of patient needs and the R&D approaches that could have the greatest impact. “We [at Genentech] have robust R&D expertise across oncology, immunology, ophthalmology, and neuroscience, but we also recognize that we can’t invent everything,” he says. “The ability to partner around the world for innovation will be critical for us to deliver solutions that will help more people living with cancer.”

A phaseless development process
Radically shifting R&D models and mounting pressure for sustainable innovation will cause medicine development timelines to continue shrinking. Garraway has been closely involved with the industry’s response to Covid-19 — and says it will provide valuable lessons for optimizing medicine development. “We’re witnessing it before our eyes in the midst of this (coronavirus) pandemic,” he says. “We’re seeing compression across many medicine development time frames and leveraging new approaches like telemedicine and other virtual interactions to speed progress. It’s certainly shown us that there’s a lot that we do that could be streamlined to allow accelerated progress, expedited access, and improved treatment decisions for patients.”

Making health equity part of the equation
Rather than only thinking about the endpoints of a clinical study, Garraway says future R&D must also evaluate how medicines may work in different patient populations, and ensure there is equitable representation across the entire process. “Inclusive research is an important ethical element of our work because it ensures we’re reflecting that diversity in our development and expanding access to those populations.”

He says that this push towards identifying and representing broader patient populations across every phase of R&D will be critical to creating a future where new treatments can be effective for every individual.

Racing towards personalized health care
Garraway’s past work as an early adopter of genomic testing technology and co-founder of the molecular insights company Foundation Medicine (FMI, which is, like Genentech, now a part of the Roche Group) has helped to advance the idea of precision medicine. At Genentech, he believes collaborations across the industry may help turn the promise of personalized health care into a reality.

Leveraging large data sets and implementing these types of technologies more broadly is just one way Garraway forsees how analytics can yield new targeted cancer treatments. The first-of-its-kind clinico-genomic database, which combines regulatory-grade longitudinal clinical data with high-quality genomic diagnostic data, can supplement or amplify existing cancer research. “Oncology remains the bleeding edge of our personalized health care application,” he says. “The idea is to leverage these approaches — both technology platforms and more traditional genetic and molecular data — to identify specific subpopulations that will respond best to our therapies.”

Patients first, always
Garraway believes that each of these areas will create major shifts in oncology R&D. But he stresses that his work has always been, and always will be, driven by a simple principle: creating maximum impact for patients. “Ultimately they are our North Star,” he says. “And the way we create impact for them across various diseases is to ensure that whatever (treatment) we go after is deeply rooted in our understanding of disease biology. Following the science will always be an anchor for us.”

To learn more about Genentech’s advancements in oncology, visit www.gene.com/topics/oncology.

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