A Personalized Approach to Oncology

Foundation Medicine is a molecular insights company, and we leverage our tests to develop molecular insights that are going to inform patient treatments.

What I'm really excited about with personalized health care is we now have the ability to impact each patient and look at each patient uniquely and individually for their underlying disease.

When you have a biomarker-driven therapy where you’re able to look at the underlying drivers of that patient’s cancer and really know that the medicine is going to target that it’s a precision medicine. I’ll use lung cancer as a great test case. Today, we know over a third of lung cancers are driven by an underlying mutation. We also know that the overall survival rate for a typical lung cancer patient, five to 10 years ago, was less than a year. And now that we're able to identify specific mutations like ALK, like EGFR, like PD-L1, we have the ability to test these patients and pair them with approved therapies; and what we're seeing is those patients are living for years.

And so precision medicine is absolutely here and now.

Partnering to Advance Personalized Care

There’s a whole ecosystem in particular in oncology and no single person can do it alone. Foundation Medicine plays an important role in comprehensive profiling and being able to understand that individual’s cancer. But it’s also really critical that we partner with people like biotech companies and pharma companies because they’ll be developing therapies towards these various mutational targets. It’s important that we collaborate with regulators because we want to get an approval for both the therapy as well as a companion diagnostic potentially on our test. And then it’s also critical that we’re collaborating with payers because if we can’t get access for patients to either testing or therapies, we haven’t really done our job.

Within the Genentech and Roche portfolio, they have a number of precision therapies. So, there’s a lot of places where we have the opportunity to collaborate across that ecosystem. We have the ability to collaborate both on the clinical development, so through patient identification in the clinical trials by testing. And also, as an example, we could be working with them to develop biomarkers or companion diagnostics.

The Power of Data

Data’s playing such a critical role in patient care today. We actually have over 350,000 patients in our database that we have deep, genomic profiles on. I think understanding the underlying drivers of an individual’s cancer and being able to look at it from an epidemiology standpoint, not just a single patient, but can I look at 300,000 patients, as an example, and see what are the main drivers of those 300,000 patients’ cancer? And then how do I develop therapies or actionable drugs towards those targets? What are the next generation of mutations that are going to be really critical in treatment and can biopharma companies develop therapies towards that?

We have over 50 biopharma partners and that’s a lot of the work that we do is partnering with them to look at actionability of those targets.

Barriers to Patient Access

The two largest barriers we’re facing today are really around access and education. Working together with payer bodies such as Medicare to get reimbursement for patients and some of the private payers. And that’s something that, again, requires the whole ecosystem coming together. Something we’re really proud of at Foundation Medicine is we’re the first and only company that does comprehensive genomic profiling that has taken our test through an FDA approval. But in parallel, taking it through access with the government with CMS to actually get reimbursement for Medicare patients. When you’re collaborating really closely, let’s say with the FDA and with CMS, you know you have the opportunity to probably impact more than 50% of cancer patients.

What we’re actually seeing today is really only 15% of patients are getting comprehensively profiled. And then more than 50% aren’t getting any testing. I think educating physicians and patients about the importance of comprehensive genomic profiling is critical.

A Personal Mission

So my mother has breast cancer and she’s had breast cancer twice, so she’s a survivor at this point. But when it personally impacts you, you start to think about things differently. We have an opportunity here at Foundation Medicine, we have a wall where we show all of our families that have been impacted by cancer. And when you walk in the door, I see that every day. I know the difference that we can make. 15 percent of patients are being tested today, and I think I’ll retire and go asleep when that’s somewhere around 95.