White House To Announce Big Push For Cancer Blood Tests

Print 19 October 2016
Matthew Herper / Forbes

The White House, as part of the Cancer Moonshot effort being run by Vice President Joe Biden, is announcing a major push to develop blood tests that can detect and monitor cancer, that aims to unite makers of diagnostic tests, drugs, and other cancer-related products.

“If you think about somebody who is at risk of cancer, or has been diagnosed with cancer, through the rest of life there is this question: Where is the cancer, what does the cancer look like? And what is going to happen next?” says Peter Kuhn, the Dean’s Professor of Life Sciences at the University of Southern California, which is participating in the effort.

The project, called the “Blood Profiling Atlas”, will try to jumpstart efforts to develop such blood tests by convincing companies to share data. “This effort is about strongly encouraging individuals who might not otherwise be caught dead together to work together for the greater good,” says Michael Pellini, the chief executive of Foundation Medicine, which is participating.

Who’s coming to the table? Companies developing the blood tests, for one thing, including Foundation, Epic Sciences, Personal Genome Diagnostics, and Guardant Health, which is donating data from its 70-gene blood test in 30,000 patients to the effort. Also, drug giants: AstraZeneca, Eli Lilly, Novartis, Pfizer, and Roche. Seven Bridges Genomics, in Cambridge, Mass, is charged with creating the web site and cloud based software that will make it possible for all these researchers to share data with one another. Toolmaker Thermo Fisher is also on board. The companies will work closely with the Food and Drug Administration and the National Cancer Institute, as well as USC, the University of Chicago, and the University of Michigan.

Right now, if doctors want to know more about a tumor, they can cut into the patient – a traditional biopsy – or they can try to learn what they can from pictures taken with PET or CAT scan machines. But recently, a dramatic drop in the cost of sequencing DNA has opened up another possibility: Look for bits of genetic sequence that tumors shed into the blood. This works because cancer happens from a buildup of mutations, and the tumor is genetically different from its host. The technology is called “liquid biopsy.”

Whether liquid biopsies will do more than just save patients from the scalpel is an open question. “We’ve had other tests along the way that attempt to detect cancer early, it doesn’t mean we can benefit our patients,” says Vinay Prasad, an assistant professor at Oregon Health & Science University. “Whether liquid biopsy can cut into new frontiers that can’t be done with regular biopsy, that remains to be proven.”

The dream is that cancer will be able to be detected with a blood test, and that doctors will use genetic information to pick the perfect drug to treat it, too. But that dream is proving difficult to realize. Some cancers are driven by a single mutation and can be treated with a single potent drug; but most of the time the benefits of these medicines are only temporary as the cancer mutates again, and escapes.

“We’ve really exhausted the low-hanging fruit,” says Helmy Eltoukhy, the chief executive and co-founder of Guardant Health. “It’s just not scalable. It needs a coordinated effort.”

One idea for how to fix this: get more eyes on the data. Seven Bridges Genomics says it plans to make it possible to allow any researcher who has the proper credentials (exact definition of “proper credentials:” still to come) to access the database it will build.

“We’re going to set up a cloud platform that let’s anyone who has appropriate approval and a good question login and do meaningful analysis,” Andrew Gruen, the director of marketing at Seven Bridges.

The big question is whether this government-based collaboration will speed things up. Kuhn says he expects it will allow researchers to do in five years what would otherwise take 10. But one major player, Grail, a spinoff of DNA sequencing giant Illumina, does not appear to be participating. And nobody really knows how much information about cancer scientists will be able to get just by taking a little bit of blood.

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