CANCER&RESEARCH&UK&& & - PowerPoint PPT Presentation

CANCER&RESEARCH&UK&& & IAN&WALKER&PHD,&MBA& DIRECTOR,&STRATEGIC&PARTNERSHIPS&

An&introduc>on&to&CRUK&

Cancer&Research&UK& Who&we&are& – The$largest$fundraising$medical$research$charity$in$the$world.$ – The$largest$funder$of$cancer$research$in$Europe.$ – The$second$largest$$global$funder$of$cancer$research$a9er$the$US$ government.$ What&we&spend& – We$spent$£338m$on$research$in$2012/13$ – We$are$almost$exclusively$funded$through$public$donaFons$ – The$money$we$raise$is$spent$on$$ • Research$ • InformaFon$ • Advocacy$and$public$policy$ &

A&UKEwide&network&with&unique&capabili>es& – 5 $ coreEfunded&ins>tutes& – 15 $ Cancer&Centres& – 4&Cancer&Imaging&Centres& – 18&ECMCs& – 7&Clinical&Trials&Units& – Our&Drug&Development& Office $

Our&Strategy&

Cancer&Research&UK’s&Ambi>on& Over the last 40 years, cancer survival in the UK has doubled. In the 1970s just a quarter of people survived. Today that figure is half. Our ambition is to accelerate progress an see three-quarters of patients surviving the disease within the next 20 years. 6$

We&intend&to&achieve&our&ambi>on&through&a&substan>al& increase&in&research&spend&in&the&following&areas& Early& Basic& Therapeu>c& diagnosis& understanding& innova>on $ research $ of&cancer $ Cancers of Cancer& Precision& substantial preven>on $ medicine $ unmet need To help deliver these priorities, we will: Launch new Invest in our Encourage Develop the funding translational collaborative best schemes network approaches researchers

Greater&understanding&of&interEpa>ent&heterogeneity&has& highlighted&its&impact&on&prognosis&&&treatment&response & Redefining breast cancer: the Mutational spectrum in Lung METABRIC study Adenocarcinoma 5 Extremely poor 2 10 *& Poor 1 Intermediate 6 9 3 4 The % distribution of clinically relevant driver mutations Good identified to date in individuals with lung adenocarcinoma. 7 8 (TGCA, Nature, 548 , vol 511 (2014)) NSCLC&pa>ent&group& PFS&gain&Erlo>nib&vs&chemo& Patient outlook Cluster EGFR$mutant*$ 5.2$mths$ 10$disFnct$clusters$with$varying$clinical$ EGFR$WT$ O1.9$mths$ outcome$ * Poor 5-year outcome; good long-term outcome if alive at 5 years * EGFRexon 19 deletions or exon 21 (L858R) substitution mutations

Significant&technology&advances,&have&accelerated&the& progress&in&precision&medicine& The dramatic decrease in the cost of Whole Genome Sequencing has outpaced Moore’s Law 1 Sanger&sequencing& Next&genera>on&sequencing& $100,000k$ Moore’s law $10,000k$ $1,000k$ Current cost of NGS whole genome sequencing is c. $4,000 $100k$ $10k$ $1k$ SepO01$ JanO03$ SepO03$ JanO05$ SepO05$ JanO07$ SepO07$ MayO08$ JanO09$ SepO09$ JanO11$ SepO11$ JanO13$ SepO13$ MayO02$ MayO04$ MayO06$ MayO10$ MayO12$ 1 : National Human Genome Research Institute, Data from the NHGRI Genome Sequencing Program (GSP) http://www.genome.gov/sequencingcosts/ .

Response&to&crizo>nib&in&ALK+&adenocarcinoma& July 2012 Sept 2012 baseline duration of crizotinib tx: 1 month Thanks to Dr Sanjay Popat (RMH), for providing this slide

CRUK& STRATIFIED& MEDICINE&&2&

A&collabora>ve&model& • The programme represents a combined investment of over £20M by the funding Partners. • Up to 14 drugs could be involved over the course of the programme.

Biomarker A : Drug A Biomarker B : Drug B Biomarker C : Drug C Biomarker D : Drug D Biomarker E: Drug E Biomarker F : Drug F Biomarker etc Drug etc Pre-screening NGS sequencing MATRIX Lung Study • 6$drugs,$14$straFfied$arms$to$begin$with$ Upto$2000$NSCLC$paFents$screened$per$year$ • • Phase$2a$signal$finding$study$ NaFonal$screening$to$naFonal$trial$ • • Rolling$protocol,$capable$of$incorporaFng$new$arms$ 28$gene$mulFplexed$NGS$panel;$detects$mutaFons,$ • • Sponsored$by$CRCTU$at$Birmingham$ deleFons,$CNV$and$DNA$rearrangement$ • PI$Professor$Gary$Middleton$ UFlising$DNA$from$rouFne$FFPE$biopsies$ • • Recruit$across$18$ECMC$centres$

SMP2:&An&Alterna>ve&Approach& Current*pathway* NHS$single$ NHS$ gene$test$ Treatment$ Single$gene$ Consent$for$ test$for$study$$ study$$ DiagnosFc$ biopsy$ Recruit$if$ EGFR$ If$test$ posiFve$ negaFve$ e.g.$BRAF$ • Shared$cost$ • Quicker$ • Easier$for$ NHS$Treatment$ paFents$ Recruit$to$drug$1$ • Fewer$ rebiopsies$ Recruit$to$drug$ 2$ • Includes$ Recruit$to$drug$3$ rare$ Collabora've** mutaFons$ Recruit$to$drug$n$ Generic$ Panel$test$$ pre,screening* consent$ e.g.$NGS$

Summary& – SMP2$will$change$the$way$we$develop$straFfied$medicines$ within$the$UK$and$provide$greater$opFons$for$paFents$with$ lung$cancer.$$ – The$programme$will$be$a$NaFonal$effort$across$the$enFre$ ECMC$network$and$beyond.$ – A$model$uFlising$shared$preOscreening$provides$benefits$for$ paFents,$Sponsors$and$pharmaceuFcal$companies$

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