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Personalised therapies for better patient outcomes

Cardiff University’s Prof Duncan Baird and Dr Magda Meissner, theme leads for precision and mechanistic oncology, say CReSt is a real opportunity to put Wales on the map.

When it comes to our bodies, we all have different needs. A universal approach to health and wellbeing is rarely effective; some of us benefit more from certain kinds of exercises that target specific areas, others might need to introduce different nutrients into their diet to combat deficiencies. 

The same applies to cancer treatment; if everybody’s cancer has a unique genetic makeup, it doesn’t make sense to apply a one-size-fits-all treatment to every patient.

Cancer genomic profiling is a cornerstone of precision oncology, enabling doctors to choose personalised therapies tailored to each patient’s specific genetic makeup. By selecting targeted therapies as part of standard treatment or clinical trials, clinicians have seen significantly higher response rates, better patient outcomes, and reduced side effects compared to traditional chemotherapy or immunotherapy. In addition, many targeted therapies offer the convenience of oral administration compared to intravenous treatments. As a result, obtaining a genomic profile as part of the clinical pathway is crucial for both physicians and patients. This step directs patients towards the most effective treatment and improves overall patient outcomes.

Precision and mechanistic oncology is, at its core, about trying to identify the right treatment for the right patient. The aim is to find therapies that match the genetics of an individual cancer, and potentially the genetics of the patient as well. 

Genomic medicine is uncovering the complexity of cancers, and cancer researchers across the world are working hard to develop targeted agents for different genes and mutations. Over the last 10 years we’ve developed technologies that allow us to characterise the molecular detail of each cancer, so we can see all the mutations that have caused that cancer, which helps us to target it with a specific therapy. However, the technology to analyse the genetics of the cancer has overtaken the ability to generate therapies. 

The development and use of genetically targeted therapy has been progressively increasing over the last 20 years. One of the earlier targeted treatments, Trastuzumab works for patients with breast cancers that express the molecule that trastuzumab interacts with, which is called HER2. But only 1 in 5 breast cancers are HER2 positive, so trastuzumab doesn’t work in all patients. 

Of course, we want to ensure that only the patients who will benefit from the drug receive it, so researchers began developing companion diagnostics. If you were a HER-2 positive patient, you would receive Herceptin. This early approach to precision medicine has been applied to a number of different agents since.

In Wales, there was an early adoption of genomic technology. We are lucky to have pockets of expertise in characterising in detail the genetics of cancers, particularly colorectal cancer. We’re trying to understand everything, from the genetics to the biology. 

Hundreds of researchers in Cardiff, Swansea and Bangor are engaged in a wide range of activities that are included within the precision and mechanistic oncology theme. By increasing collaboration opportunities and wisdom-sharing through CReSt, there is a real opportunity to put Wales on the map.

We would like to see more interaction across disciplines, from geneticists to drug developers, that could help us to push this research area forward and potentially develop more targeted therapies that could save patient lives in Wales and beyond.

We would also like to see Wales become an attractive destination for new labs and researchers. By stimulating investment into Welsh cancer research, we hope to encourage current and future talent to establish their research activities in Wales and to develop their careers here. Research-active hospitals result in better patient care as new treatment avenues and trials are explored, and more innovative options become available.

There is a great breadth of talent in cancer research across Wales. By stimulating activity, investment, and collaboration, we believe that CReSt can make a real difference to the outcomes of patients with cancer across the world.