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The future of care in metastatic urothelial carcinoma and the role of the FGFR pathway

23 Sep 2020
The future of care in metastatic urothelial carcinoma and the role of the FGFR pathway

This feature has been funded by Janssen Europe, Middle East and Africa (EMEA)

 

Author: Dr Joaquín Casariego, EMEA Therapeutic Area Lead Oncology, Janssen

 

Janssen in oncology

Cancer. One word that makes us swallow every time we hear it or have to say it in front of our patients.

Often a devastating and relentless disease that we - the medical community - are fighting back against. And our fight is working; times are changing. Now that word doesn’t automatically mean an early death sentence. Decades of research driven by our collective achievements and ambition is flipping cancer on its head. Many patients across different therapy areas are now living longer and certainly with better quality of life. This is thanks to the driving force of the medical community, where we strive to never stand still and to keep advancing our knowledge for the benefit of those who have to hear that word.

It’s truly inspiring. Now more than ever, the passion of the oncology community is definitely shining through. In this time of a global pandemic, we have come together and adapted to make sure that we can maintain our momentum in our mission to one day find a cure for cancer. The European Society for Medical Oncology Virtual Congress is true testament to this. While we may not be able to meet face-to-face, we will not let this get in the way of sharing knowledge and inspiring each other to find the next advancement that we hope will help to eradicate cancer in the future.

Through my work at Janssen, I am proud and privileged to be at the forefront of pioneering new approaches to advance our industry.

When it comes to treating cancer, we are all very aware that catching the disease in its early stages is key to more successful outcomes. And we’re heavily investing resources and tireless effort in striking key cancer types at the earliest stage possible, through innovative patient centred research. But some of our Janssen scientists are taking the idea one step further: they are trying to intercept suspicious cells before they become malignant and begin proliferating.

The premise behind the new strategy, known as cancer interception, is to figure out why some healthy cells turn cancerous, so treatments can be developed to interrupt that process—and potentially thwart the disease earlier, before it invades the body.

I am extremely excited to see how we continue to hit the disease at the earliest possible stage at Janssen. By working together, we may one day make this cutting-edge concept a reality, and so create an enormous value for patients, their families and the health system.

 

The right treatment for the right patient

While my dream, and that of my colleagues, is to stop cancer as early as possible  -  preventing anyone having to hear the words “you have cancer” - we must all acknowledge that there is still a long way to go to reach our goal. For the more than 3.7 million people in Europe who receive a cancer diagnosis each year, our focus must be to make sure there are treatments available to them that will respond to their specific cancer.1

The role of biomarkers is very well established in oncology. The benefits of a precision medicine approach to treatment are demonstrable in the clinical setting, particularly within metastatic stages of disease.2 By identifying which pathway is leading the growth of a tumour, we can aim to stop or delay disease progression.3,4 This can have profound benefits for a huge number of patients. Indeed, recent evidence has shown that 93 percent of all urothelial tumour specimens have at least one actionable alteration.3

In certain tumour types however, there has been a significant lack of innovation towards precision medicine. One such area is urothelial carcinoma. With approximately 151,000 new cases diagnosed each year in Europe, there is critical and urgent need for us to find new, innovative solutions that can address the poor clinical outcomes faced by these patients.5

 

Bladder cancer and the FGFR pathway

At Janssen, we are pioneering research into biomarkers for patients with urothelial carcinoma.4 As many as 20 percent of patients with advanced urothelial carcinoma have alterations to the fibroblast growth factor receptor (FGFR) genes, making this a potential area for us to focus on for future of treatment options.6 I am extremely excited to be part of this cutting-edge research that, I hope, will result in life-changing results for patients and our medical community.

There is limited evidence and conflicting approaches within the current treatment guidelines for advanced and variant bladder cancer management.7,8

One solution may lie within the FGFR pathway.4 Treatments that specifically target these genetic alterations may provide us with a vital option for patients who are currently unlikely to see clinical improvements with the treatments that are currently available to them.4,9,10,11,12

I am truly excited about the progress we are making to rectify this unmet need at Janssen, and what this might mean for patients and families across Europe.

 

Leading advancement in bladder cancer

I passionately believe that no one person or organisation can win the fight against cancer. It takes the best ideas from across the globe. This means working in partnership with other health-related industries, academia, governments, health organisations, healthcare professionals, patient organisations and society as a whole.

The foundations of our solid tumours research approach at Janssen stems from our decade-long heritage in the study of prostate cancer. This provides us with a critical platform to expand on as we look to increase our understanding. From the approval of our first prostate cancer treatment in 2011, we have continued to build on the insights from our clinical research, leading us to now having five approved indications in prostate cancer with more indications currently in late-stage investigation.13,14

It is this knowledge that we take with us in our fight against urothelial carcinoma. Our ambition is to ensure that patients have access to the right treatment, and the right time. This can only be achieved by investing in novel research and development of drug delivery systems and cancer interception.

This sentiment is held by my colleagues as well. In 2019 Janssen acquired a leading clinical-stage product, which uses a silicone-based drug delivery device that allows for the continuous release of medication into the bladder.15

The technology provides us with a first-in-class clinical stage platform to evaluate novel, locally delivered therapeutics for patients with localised bladder cancer.15 This will help us to advance treatments for our patients and also push us towards early interception of bladder cancer – hopefully getting us one step closer to that ultimate goal of cure. We are proud to be at the forefront of developing new technologies to ensure physicians and patients have tailored solutions that deliver against the expected outcomes.

 

Continuing the fight for patients

My work is extremely exciting—it keeps me awake at night! From a research perspective, we are exploring totally new territory. We are not repeating the work that other people have done. This means that everything - from the design of our clinical trials to patient selection - poses unique challenges. I wholeheartedly embrace these challenges each, and every, day. The driving passion behind it is to find a cure, and then vast numbers of people won’t have to live in fear, wondering when or if they’re going to develop cancer. I have high hopes for our research. I am very much looking forward to the day when the words “you have cancer” will be less terrifying for patients to hear and less distressing for physicians to say.

 

CP-178913

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