Making Precision Oncology the Standard Worldwide - An Interview with the Precision Cancer Consortium

Good afternoon, today we are delighted to welcome the Precision Cancer Consortium Chair - Gabriele Allegri, Vice President for Global Commercial Precision Medicine, Johnson & Johnson Innovative Medicine, and Vice Chair - John Longshore, Head of Scientific Affairs for Global Oncology Diagnostics, AstraZeneca. 

Thank you for the invitation. It's our pleasure. 

Can you please start by sharing the vision and mission of the Precision Cancer Consortium?  

The procedure Cancer Consortium (PCC) was funded in back in April 2022, and since then extending in terms of number of companies, project and impact generated. The PCC is dedicated to a future where every person with cancer - regardless of who they are or where they live - can benefit from precision oncology. Through global collaboration, we work to make biomarker informed, data-driven patient identification and personalised care standard practice, ensuring that the right treatment reaches the right patient at the right time. 

Why is it so critical to make comprehensive genomic profiling (CGP) the "new normal" in cancer care, and what inspired this consortium-led approach?  

Far too many patients around the world have limited access to precision oncology, and this is a huge barrier to optimal care and outcomes. A 2002 paper by Diaceutics showed that even in a highly developed diagnostics market such as the US, roughly 64% of potentially eligible patients with advanced non small cell lung cancer did not benefit from precision oncology therapies appropriate for their disease. That really is a tremendously huge and shocking number. The paper identifies seven clinical gaps where patients are lost, including pre analytic, post analytic practice challenges that occur across the diagnostic ecosystem. We know this is not unique to the US and other countries face similar problems and these challenges are ecosystem related and really cannot be solved by 1 stakeholder within the healthcare system. So, the PCC helps to facilitate collaboration to address challenges like this regarding access to precision oncology and biomarker-informed, data-driven decision-making for all cancer patients globally. 

We also have to say that we're looking beyond comprehensive genomic profiling. The diagnostic testing landscape is evolving quickly. Developments in immunohistochemistry, digital and computational pathology are certainly on everyone's mind these days. We’re dealing with more and more data from multi-omics, which AI may help to collate and analyse. There have also been great strides in monitoring cancer with minimal residual disease to look for cancer recurrence and an early cancer detection. So, we also have those on our radar. 

The PCC is interested in all of these approaches and applications to help create a deeper understanding of each patient’s individual cancer and how to best treat it. We’re working hard collectively to ensure that all patients have the opportunity to benefit from these advances. 

What are some of the key ecosystem-level barriers the Precision Cancer Consortium has identified in implementing comprehensive genomic profiling globally and how do these challenges differ across localities?  

Heterogeneity in practice and availability of testing is a huge challenge in precision oncology. A recent European study published in 2022 by Nicola Normano found that availability of biomarker tests was as low as 40% in some countries but up to 100% in others. Uptake of multi-biomarker next generation sequencing (NGS) ranged from 0% to >50%. PCC has identified top three ecosystem level barriers. First one is financial constraint, second is lack of NGS testing capabilities and 3rd is the failure to include NGS testing in the guidelines. Now what are we doing as APCC to overcome those barriers? Let me give you 3 very specific examples. 

One on the financial constraints, that are a frequent challenge in many parts of the world. Through the Access to CGP project, we are taking direct action in a region of Spain, which we intend on using as a model for similar regions globally. Our value framework and genomic test cost calculator projects help build the financial case for comprehensive genomic profiling.  

Second example is on capability building. We can improve the education and awareness around the benefits that comprehensive biomarker testing can bring to patients, as well as discussing its practical application. The PCC has run several global and local webinars and virtual workshops to help address this, as well as a symposium at the European Congress of Pathology (ECP). The PCC are releasing training modules on Lean Six Sigma, and how these principles can apply to diagnostic testing laboratories to make workflows more efficient. 

The third example I want to give is about liquid biopsy. Liquid biopsy (LBx) is a powerful tool with variable uptake around the world. Its potential has been clearly demonstrated, so the PCC are working in France with key stakeholders to remove specific barriers and increase its usage. As with the Access to CGP project in Spain, the lessons and solutions will be scaled up and shared for global benefit. A manuscript sharing some of the underlying research is currently in development, and this will showcase some of the regional differences that we observed. 

Those are examples that demonstrate that by working across different aspects of precision oncology and diagnostic testing, we can address the various challenges that are faced in different regions, institutions, and amongst individual stakeholders for the benefit of our patients. 

Could you please walk us through one or two flagship initiatives the Precision Cancer Consortium has undertaken and the specific problems they aim to address?  

Certainly, as Gabrielli just mentioned, our two main investments currently are for improving access to testing in Spain and improving uptake to liquid biopsy in France. These initiatives involve working directly with key stakeholders such as governmental organisations and regional testing labs to tangibly change the testing landscape on the ground. The outputs and learnings are not really restricted to Spain and to France, but we hope to scale these projects up and make them into global efforts in due course. 

Beyond these two flagship initiatives, we’d encourage viewers to visit the PCC website (www.precisioncancerconsortium.com) and download the various tools that we have made available including: the Genomic testing cost calculator, the Lean 6 Sigma modules, and an educational webinar series on the incorporation of biomarkers into clinical trials. We share these tools freely and openly for the benefit of the entire diagnostic community.  

We also encourage viewers to follow PCC on LinkedIn. This is where we share articles from key opinion leaders and announce the availability of new tools and PCC initiatives. We have manuscripts in development for several of our projects, such as the Value Framework and liquid biopsy work. We’ll announce the availability of these publications soon on the PCC LinkedIn channel. 

Can you please highlight some of the impacts or early outcomes from these initiatives - particularly those involving AI-driven clinical trial matching or the value framework for comprehensive genomic profiling?  

AI has huge transformative potential in healthcare. It’s potential uses span drug discovery, early detection and diagnosis, disease management, treatment selection and patient monitoring. 

The AI-driven clinical trial matching was a fascinating project. Manual screening of patients for cancer trials is traditionally a resource-intensive process. Our pilot project demonstrated that combining NGS and AI nearly doubled the potential eligibility for patients for clinical trial enrolment across various tumour types. It also achieved a twelve-fold increase in matching efficiency for specific tumour profiles, significantly curtailing manual labour. 

The AI testing landscape has changed markedly since then, with new tools becoming available and quickly evolving. Within diagnostics specifically, AI can match patients to the right trials, automatically analyse pathology slides, or collating and simplifying large data sets from multi-omics analyses. The PCC are keen to see where AI takes us and where we can make a difference moving forward. 

For the value framework, we are expecting a publication very soon, so no spoilers from me! The framework provides a standardised approach to evaluating the value of NGS panel testing. The value framework includes a robust, transparent set of criteria across multiple domains to objectively support resource allocation in cancer care.   

Making the financial case for precision oncology is vitally important to drive uptake. In addition to the value framework, the PCC and IQVIA have developed a genomic testing cost calculator. This is freely available on the PCC website. It allows users to evaluate the costs of NGS panel testing against single gene testing. In many cases it may be more cost effective to run a panel providing a wealth of information, than it is to run several single gene tests. 

The Precision Cancer Consortium brings together six major pharma companies. How does this multi-stakeholder collaboration model function in practice?  

Our collaboration is generally very straightforward and effective. Each member has a board representative, that provides strategic oversight and governance to the group. Our aligned mindset and goal makes this simple – each member company is trying to improve access and availability of biomarker testing, so it makes total sense to do this together and we realise that we can all achieve more collectively than we could as individual companies.  

The execution of projects is delegated to specific teams comprising colleagues from our respective companies that do this on a voluntary basis, as well as trusted vendors and partners. This is done out of a commitment to improving the lives of patients in addition to everything they do in their day jobs. We really recognise and truly appreciate the extraordinary efforts that our team does to ensure the success of PCC projects, and have started a series of Wayfinder Awards that you can see on the PCC website and LinkedIn channel that lists some of these hard working individuals from our member companies as well as our partners. 

What lessons have emerged from working across such a diverse consortium, and how have those shaped your approach to new projects?  

Although each individual PCC member may have differing immediate priorities or interests, ultimately the ability to comprehensively test patients is foundational to precision oncology. While our R&D teams work on unique therapies and our diagnostic partners on ever-improving diagnostic technologies, the challenges to access and availability of those tests apply to all of us. We owe it to our patients to work together to improve the testing ecosystem. 

The PCC has remained technologically neutral and agnostic of tumour type. We work on the common ground and decide on which projects to support accordingly. All our projects are about improving access to testing in some way, shape or form, be that educating clinicians via webinars or improving access to approaches such as liquid biopsy. 

Looking ahead, what are the strategic priorities for the Precision Cancer Consortium and how do you see its role evolving?  

When we started the PCC improving the uptake of comprehensive genomic profiling was a shared goal for member companies. Since then, the diagnostic testing landscape has rapidly and we have new opportunities and also a lot of new challenges and complexities that that have emerged in the diagnostic landscape. 

So, as we look ahead, we look beyond comprehensive genomic profiling alone, as I mentioned earlier. So digital and computational pathology, the use of AI, multimodal diagnostics, minimal residual disease and therapy monitoring, along with early cancer detecting, true multimodal diagnostics. And at the end of the day, making sure that all diagnostic methodologies are not barriers to patients getting access to appropriate therapies is our goal. 

Where possible, the PCC encourage the use of the most comprehensive testing and analysis that is viable in each consensus thesis to identify biomarker with potential utility both today and in the future as a new therapy and clinical trial options may become available during a patient cancer journey. 

We also encourage organisations who are interested in partnering with or joining the PCC to reach out to us via our website or directly. 

Thank you to the organisation for this nomination, for the Precision Medicine Awards 2025. It means a lot to us. The Precision Cancer Consortium unite leading pharma companies to make precision oncology and comprehensive genomic profiling the global standard of care by tackling barriers such as funding, limited NTS capability and gaps in guidelines. The PCC drive practical solutions from AI driven clinical trials matching to cost calculator and clinician education. Looking ahead, the PCC will expand into multimodal diagnoses, early detection and minimalism disease monitoring. We have a continuous mission to ensure that every patient gets the right test and treatment at the right time because every patient, everywhere, should have the best chance at the best care. 

Fantastic, thank you very much. 

Thank you very much again to John & Gabriele for your time today and for sharing such fantastic insights into the very important work of the Precision Cancer Consortium. 

Thank you both very much.