Mark Garner, PhD., Global Cancer Segment Market Manager at Agilent Technologies, recently sat down with DDW Editor Reece Armstrong to tell us about the developments in the ‘golden age’ of cancer research.
RA: Please can you tell us a bit more about your role at Agilent?
MG: I am responsible for Agilent’s cancer segment. You could describe my role as being a convener across all our cancer research-related product lines, our Medical Affairs team, and the rest of the organisation. With my holistic view of our cancer research solutions, I help our team to develop solutions and workflows that meets the unique needs of customers in the field. In order to be that ‘voice of the customer’ within the organisation I have to spend a lot of time listening to customers, to hear and understand their needs, their aspirations and frustrations. That’s the vital part that so many organisations miss.
The European Commission notes that whilst Europeans only make up one tenth of the global population, 25% of annual cancer cases fall within Europe.1 The likelihood is that we all know someone who has been affected by cancer; speaking for myself, three members of my immediate family died from various forms of cancer. A fulfilling part of my job is meeting the scientists, companies, and institutions at the forefront of ground-breaking research that are advancing patient health outcomes.
RA: What is the current state of the cancer research industry?
MG: We’ve entered a revolutionary period for cancer research, an era which the former Director of the US National Cancer Institute called the ‘golden age of cancer research’. It’s a brilliantly exciting time where we’re beginning to harvest the fruits of decades’ worth of breakthrough research undertaken by the world’s brightest scientists, and we’re seeing those advances in basic science translated to the clinic, where they’re making a difference in patients’ lives. The scientific community has 50 years of research fundamentals under their belts to make a substantial difference in patient care, particularly in the areas of immunotherapy and precision oncology. Through such therapies, slowly, hesitatingly, some people are using the word ‘cure’ with a few individual cancer patients, which is something the field has avoided for decades.
We’re starting to see that this goal is realisable. In the recent Lancet Oncology Commission report on cancer research in Europe, they have identified 12 key recommendations, which, if followed, they predict will drive their 70:35 vision, i.e., 70% long term survival rate for all European cancer patients by 20352.
RA: How are these new scientific advances helping fight cancer?
MG: Immunotherapy is a great example of this. Decades of research on the cellular and molecular mechanisms of how the immune system detects and kills cancerous or pre-cancerous cells, known as immune surveillance, and the factors which modulate that response, have led to understanding how we can enable a patient’s own immune system to fight cancer more efficiently in different ways. For example, in CAR-T-cell therapy, scientists can take T-cells from a patient and ex vivo (outside the body) genetically engineer them to effectively target and kill cancerous cells, then infuse them back in to the patient. It’s still limited to haematologic cancers, and isn’t always effective, but just the audacity of the concept is really astounding.
Precision oncology supports targeted therapeutic treatments by determining the specific molecular characteristics of a tumour – the molecular phenotype, as it’s called – to obtain an in depth understanding of the patient’s unique cancer and using it to specifically target the patient’s cancer on a molecular level. These types of therapies are often more effective and have fewer side effects. When it comes to cancer treatment, the one size fits all approach is no longer prevalent or viable.
For example, if a patient’s tumour has a particular protein present, called a checkpoint protein, this will reduce the response of T-cells. Protein therapeutics have been developed which bind to the checkpoint protein and “blockade” it, to prevent the moderation of the T-cell response, thus “turning up” the immune response dramatically.
Of course, if a patient’s tumour does not have this protein, then this type of treatment won’t be effective. A big part of precision oncology is companion diagnostics, to determine if a patient will respond to a drug. Companion diagnostics are vital for the development of precision oncology treatments which are more targeted, more specific, and are less likely to have side effects.
RA: How is Agilent supporting cancer research?
MG: Agilent works as closely as we can with the researchers, clinicians, and pharmaceutical companies that are at the forefront of developing therapeutic strategies to understand what they need from a technical point of view. We have leading expertise in the field of cancer research particularly with our cell analysis portfolio. Cell analysis underpins many revolutionary cancer treatments, with many immunotherapies utilising cells themselves to kill cancerous cells.
For example, scientists must measure the metabolic function of both the cancer cells and, as we now understand, the metabolic state of the immune cells attacking the cancer in real-time as well. These are very dynamic processes – I think of it like a predator-prey relationship – so being able to watch them change in real-time, and not just grab a static snapshot is crucial. We need to go further relate these metabolic changes to potency of the immune response – how effective are the immune cells in identifying and killing of cancer cells, and the persistence of that killing. We need that integrated, system level understanding.
I was just at the American Society for Hematology Summit on Immunotherapy, and the issue of analytics, especially for cellular therapies, was a topic of discussion, both in the context of research but also what are the ‘Critical Quality Attributes’, as the FDA refers to them, which one monitors in process and what are the appropriate techniques to measure them. What is clear is that what is needed are methods which can start in the research lab and ‘cross the chasm’ to routine use in a regulated environment.
RA: Is Europe a leader in global cancer research?
MG: I meet regularly with the brilliant European scientists driving cutting edge global cancer research. Europe is a hub for comprehensive cancer centres where basic research, clinical research and clinical care are centralised within one institute. For example, Cancer Core Europe is a collaboration of seven leading cancer centres which deploy this model to propel cancer medicine. Having the different elements of cancer research under one roof catalyses translational research which will eventually have fantastic outcomes for treating cancer in patients. With the growing presence of centres like these, I see Europe as a leading region for robust collaboration in cancer research at an international and institutional level.
RA: What’s next for cancer research/the industry?
MG: The focus now is to bring new cancer treatments based on radical science like immunotherapy and precision oncology to the patient bedside at scale. The ambition for the future is to have these treatments as accessible as possible, so we can move closer to a world without cancer. The industry and scientific community are becoming more agile to enable this transition.
For example, a traditional therapeutic development model previously involved academics conducting research and basic therapy testing before handing over the research to a pharmaceutical company for drug discovery and diagnostics. Now, we’re seeing more academic institutions at the forefront of running clinical trials and diagnostic solutions to bring treatments directly to patients.
Vendors must respond to the need for agility and resilience in the development of cancer treatments and therapeutics. We must work closely with pharmaceutical companies to understand exactly what their needs are, anticipate the demand for new technologies and with them, develop companion diagnostics while they conduct drug development. Creating a robust ecosystem to bring treatments to patients as effectively as possible.
Mark Garner received his Ph.D. in Biochemistry from Michigan State University. As part of his graduate work he invented the gel-shift or EMSA assay for the study of protein-DNA interactions. He was then an American Cancer Society Postdoctoral Fellow and National Research Service Awardee at the NIH, as well as doing a second postdoc at the University of Wisconsin-Madison. Garner also developed a long-term relationship with the Max Planck Institut für Biophysikalische Chemie in Göttingen. He is currently Global Cancer Segment Manager with Agilent Technologies.
- Lawler M, Davies L, Oberst S, et al. European Groundshot—addressing Europe’s cancer research challenges: a Lancet Oncology Commission. The Lancet 2022. Published online Nov 15. https://doi.org/10.1016/S1470-2045(22)00540-X