NEW DRUGS AND PERSONALIZED MEDICINE
New drugs and personalized medicine
The main areas of research are focused on identification of new targets and biomarkers and on testing new drugs in small populations.
The targeted agents in patients with targetable molecular aberrations improve clinical outcomes but gaps remain in identifying driver molecular alterations in patients with multiple aberrations and molecular networks that affect tumor development and drug resistance/response.
For lung cancer the research group investigated if the co-presence of KRAS and LKB1 mutations can confer a more unfavorable prognosis.
For ovarian cancer aberrant methylation and HER 2 status are useful for individualized treatment.
Under investigation are the immune checkpoint inhibitors due their promising results in achieving significance and durable treatment responses with manageable toxicity. The PD-1 inhibitors Pembrolizumab and Nivolumab but also the PD-L1 inhibitors Atezolizumab, Avelumab and Durvalumab have been shown to be helpful in several types of cancer in clinical trials.
Undefined is their role in earlier stages of NSCLC (adjuvant setting or in conjunction with radiation or chemo-radiotherapy, in stage III).
One concern is the search of the most appropriate predictive marker that can use to guide to who will benefit most. PDL1 testing can be heterogeneous within a tumor and with different level of expression between the primary tumor and the metastatic disease.
Another point is the most useful ways of making monoclonal antibodies more effective. Combination therapy such as CTLA-4 antibodies plus PD-1 / PDL-1 inhibitors for “dual inhibition” of immune checkpoints or PD-1/ PDL-1 inhibitors plus chemotherapy or targeted therapy is an important approach.