ORIGINALLY PUBLISHED:
17 April 2023
Written by:
Andrew Reynolds
Senior Director, Oncology R&D, AstraZeneca
By the time cancers are diagnosed, they have often been evolving for several years. To achieve long-term survival and potential for cure, we must find new ways to treat cancers early. What if we could develop medicines that prevent cancer in the first place?
We’re already developing early detection technologies, and progressing our diverse portfolio of new treatment modalities to attack cancer from multiple angles. Now, driven by our ambition to one day eliminate cancer as cause of death, we aim to understand how to overcome the challenges we may face in developing preventative cancer medicines.
Our recent publication in Cancer Discovery leverages our expertise in drug development and offers an industry perspective on the steps we think are necessary to develop next-generation cancer medicines to treat early stages of disease.
Identifying cancers at the earliest stages
Despite the number of medicines available for advanced stage cancer, only a few medicines have been approved for cancer prevention. A notable success has been the vaccine against the human papillomavirus (HPV) which dramatically reduced the incidence of cervical cancers and related deaths in the countries that have adopted its use.
Although preventative medicines are still sparse, advances in our understanding of how cancer develops provide new insights into how we might prevent it. We know that many cancers have a phase of ‘premalignant disease’ when treatment is likely to be more impactful, and that certain risk factors, for example inherited risk factors, predispose individuals to developing cancer. Identifying premalignant disease, or those people who have inherited risk, are both examples of where there may be an opportunity to intervene early. At the moment, researchers are exploring the potential use of existing cancer medicines as preventative agents, while developing novel medicines for prevention as well.
Cancer evolution and the drug development paradigm
Addressing the challenges associated with developing preventative therapies for cancer
In our review paper, we focus on overcoming the challenges associated with developing medicines for cancer prevention. These include identifying high-risk populations expected to gain the greatest benefit from treatment, selecting the right medicine, the right dose and the right treatment schedule.
To increase our chances of success, we draw on previous cancer prevention research and drug development for other diseases, to propose six areas of focus in the development of preventative cancer medicines:
- unmet clinical need
- patient identification
- risk stratification
- pharmacological intervention
- clinical trials
- healthcare policy
Ultimately, future success in developing medicines to prevent cancer will depend on collaboration between experts driving the development, approval and prescribing of new medicines, and having an approach which is driven, above all, by patient benefit.
What next for preventative therapy in cancer?
Over the next few years we will continue to seek new insights to preventing cancer. With ongoing exploration and a deeper understanding of cancer risk, premalignant disease and early disease, we hope to one day deliver life-changing, preventative cancer medicines to patients.
