Roche, one of the largest pharma companies in Europe, has been expanding its ambitions in genomic and personalized medicine, emerging practices that use information about a patient's genetic profile or proteins to prevent, diagnose or treat disease. 

Dr. Oliver Bleck, area head of Europe South at Roche, joined MobiHealthNews to discuss Roche's advancements in oncology, its current work in genomics, and what Roche hopes to contribute regarding personalized medicine as time progresses.    

MobiHealthNews: You've had a long career at Roche. How have you seen oncology treatment advance over the past 20 years, especially when it comes to digital healthcare?

Oliver Bleck: The overarching sentiment is it has moved away from a one-size-fits-all to targeted therapy, to more individualized therapies. I'm a medical doctor, and before I joined Roche, I had the chance to work in dermatology. And what comes to mind is the treatment of melanoma patients back then.

Some 20 years ago, once in a certain stage, there was no effective treatment to stop metastatic melanoma from growing, regardless of what medicine had to offer. So over the years, it was fascinating to see that two important things came along: one, the better understanding of melanoma biology and then targeted therapies, which not only stopped the tumor from growing but actually helped melanoma patients live longer lives. And two, the first immunotherapy in cancer that was approved was also in melanoma.

The understanding of breast cancer biology has led to the approval of a monoclonal antibody targeted to a specific cell receptor or two, which then led to very effective therapies for advanced breast cancer for the patients who would carry this marker, and also helped the patients live not only longer, but actually get cured because of this treatment strategy. Something similar in hematology, the addition of a monoclonal antibody with a standard chemotherapy has also helped lots of patients live longer lives. 

MHN: How have the advancements Roche has made in oncology progressed treatment options for patients and providers?

Bleck: I would argue on three angles: one is better diagnostics. But it's not only for Roche medicines, but for other partners in the pharma industry to help early diagnosis, to help treatment follow through, bring up companion diagnostics and – in partnership with other companies – to be in the space of comprehensive genomic profiling. So, understanding the genetic fingerprint of each tumor type and then every individual to a patient level.

The second bit is the therapies. We have a huge set of different modalities, small molecules, monoclonal antibodies that I mentioned, and for sure cancer immunotherapy. We have multiple indications in five disease types – tumor types in the U.S. – and a lot of work is going to refine this immune-treatment strategy. It doesn't work everywhere, but [it helps] to better understand biology, how this can be augmented and so forth. 

The third part is around data – to really understand how treatments are working with real-world data evidence in clinical practice. 

Right now, I think the overall mission is to move to earlier diagnostics, and also to move cancer care to earlier stages of the disease. 

And there's five distinct overarching themes on how to pocket all these activities. One is to pursue precision medicine, so better diagnostics and then fitting the treatments there. Second would be rational combination therapies – given the profile, what is the best treatment strategy forward?

The third one is a better and more enriched immune cancer therapy. The fourth one would be moving to earlier stages. And then the last one is new treatment modalities. For example, the bispecific monoclonal antibodies that help not only to target a specific cancer cell, but via the second activity attract T cells that would help fight the cancer.

MHN: Genomics has become valuable in the fight against cancer, but is not readily available in low- or middle-income countries. Why is it beneficial to expand those options to those countries?

Bleck: Foremost, it should not matter where you live in order to get the treatment that you need as a cancer patient. I think striving for ubiquity and access and the best care, it's an overall mission. And so, for good cancer care, and also from a perspective of a healthcare system, it makes a lot of sense to pursue precision medicine or to be exact on the diagnostic because it will also tailor the treatment. 

The second one is via digital means and virtual tumor boards. You can access experts' opinions in the U.S. and Europe somewhere if you are in an area where you're more remote. So by just having a good diagnostic, this could help the patient where they are.

But I think genomic profiling makes sense if you have good medical care in your area – the hospital, the diagnostics, and if you give chemotherapy, the staff that can treat and help with the side effects. Just the genetic profile for a patient, if there's nothing following, is useless. It has to be a system change and lobbying for a better service. But lots to do. I agree.

MHN: As time progresses, what do you hope Roche can bring to the table as far as personalized medicine goes?

Bleck: Continuing on the public-private partnerships. So, working with the various stakeholders and academia to advance the field. No one [company] can figure it out. We work with other pharma companies and also with academia. So hopefully, that will help, in a concerted effort, a call to collaboration, to make progress.

Second, as a leading company in the field of diagnostics and therapies, augmenting with digital solutions around the patient journey will help physicians, but also patients for better treatment.

Plus, also this element around data – understanding what's really happening, being able to share this data, aggregate this data to bring to regulatory authorities to outline here's the treatment strategy that works.

It's not about owning the data, but it's coming together and doing the research out of it. We may have different questions as a company, compared to an academia field, but I think it's really important, especially in Europe, that patient data can follow you as a patient if you go from one country to the next. Plus, we find a way to look at anonymized, larger datasets that hopefully show us the way on how to improve oncology treatments quicker.