ESMO 2016
Biomarkers of sensitivity and resistance
Dr Joan Seoane - Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
This meeting is about how to characterise tumours and based on the knowledge of the tumours we will be able to treat them correctly. So we can do that by analysing biomarkers within the tumour piece, by characterising, for example, the genomics, the transcriptomics, the epigenomics but also we can look for circulating biomarkers that will tell us also information about the tumour and that you can look at circulating tumour cells, you can look at circulating tumour DNA or even exosomes in some cases. Finally we can also assess and functionally determine whether the biomarkers are good by using patient derived models. These models are models that are generated from specimens of tumours that are obtained from patients that we can culture or we can inoculate into mice in order to recapitulate the tumour of a patient in a mouse and then characterise it.
Could you tell us a little about the Conquering Resistance session that you also chaired?
In terms of the Conquering Resistance it’s also linked to this concept of biomarkers. If we really understand the characteristics, the molecular characteristics of tumours we will be able not only to know which is the correct treatment but we will be able to predict how the tumour will escape to that treatment, so how the tumour is going to find a way to generate resistance to the treatment. We are observing, for example, now that upon several targeted treatments there is some population of cells that are selected, there is a selective advantage for this population of cells to grow and these cells are going to be resistant. If we know which are these cells, which are these characteristics we will be able to prevent resistance by using another treatment or a combination of treatments.
And Dr Cruz spoke about resistance too…
This was a session precisely on this, on resistance. Both in two different ways it was two posters, one in colon cancer and resistance to the EGFR inhibitors, the other one was in breast cancer and resistance to PARP inhibitors. In both cases it’s the same thing – trying to understand the molecular mechanism of action of these compounds, try to assess how the cells are acquiring resistance and then act accordingly to try to prevent resistance by a combination of treatments. In the session about Conquering Resistance what we did is try to look at different levels of resistance. It can be resistance by mutations, by genomic alterations, either by acquiring new mutations or by primary mutations that are selected, but it can be also at the level of signalling – different pathways that can circumvent the inhibition of one of the pathways due to the treatment and in this way the tumour can escape. So these different ways of resistance are very important to understand in order to be able to treat them.
Where would you like to see this research going next and in the future?
What is clear to me is that knowledge will allow us to have better treatment. So what we think is that by technological advances and also by full in-depth study of the mechanism of action of some compounds or even the biology of cancer we will be able to have better treatments, better combination of treatments because in this way we might be able to circumvent resistance, and also better biomarkers, maybe circulating biomarkers that can allow us to monitor tumour evolution and tumour growth in a better way, in a way that we will be able to know exactly what we are treating at the very moment that we need to treat.
Any closing thoughts?
I am also the representative of the EACR, the European Association for Cancer Research and I think here it’s a crucial concept to try to put together ESMO and EACR to generate this translational effort where we can synergise and try to get better treatments by knowing and understanding the mechanism of action of some compounds, research plus the clinical action towards the patient.
