How Precision Medicine is Changing Cancer Care

In this interview, Debyani Chakravarty, PhD, from Memorial Sloan Kettering Cancer Center, discusses her session on scaling precision medicine for equitable cancer care. She spoke at the 2023 Clinical Pathways Congress + Cancer Care Business Exchange as part of a session titled “Scaling Precision Medicine Expertise for Equitable Cancer Care: Breaking Barriers, Advancing Patient Outcomes.”

Transcript:

Debyani Chakravarty: My name is Debyani Chakravarty, my title is Assistant Attending at the department of pathology and laboratory medicine, I am also the lead scientist for Onco KB at Memorial Sloan Kettering Cancer Center.

What are you most excited to share with attendees?

Debyani Chakravarty: What am I most excited for? I think, I’m most excited for the fact that disparities in healthcare, disparities in patient communities, is something that is very present and very it’s present in every community that is in the industry it’s always been a ground truth for patients, it’s always been a ground truth for communities within the US, but for the first time I think in a long time it’s become a matter of crucial sort of resolution and taking steps towards it and I am excited for what that energy and what that vibe will bring to cancer care and precision medicine in general.

How has precision medicine revolutionized cancer care?

Debyani Chakravarty: That’s a great question, so, in 1998, we’ll start in 1998, there was one biomarker HER-2 amplification for patients with breast cancer that were HER-2 positive by immune chemistry, now that’s one drug, now 43% of FDA approved oncology drugs are all precision medicine. There has been an absolute explosion in the number of FDA approved drugs that rely on precision oncology technology, on genetic testing of their patients and so that extent and extrapolation of knowledge that extrapolation of research that has happened, has really buoyed precision medicine and now, ya know, the single biomarker giving rise to a single FDA approved drug, that’s giving rise to combination drugs with lesser toxicity, more selective drugs in order to really prevent off target effects. So the field keeps growing, but it’s now growing in different avenues, which is very exciting.

Can you talk a little about the importance of a community grassroots campaign to assist with clinicians' adoption of new tools?

Debyani Chakravarty: Absolutely, so, I think, because of this new energy were realizing that many patients are getting left behind because were not speaking to that community with their own language and understanding and empathy for what those communities are going through. I think John Sweetenham from in our session, put it perfectly, in a study where patient navigation which is really simple simple effort managed to increase the concordance of black patients to NCCN guided drugs and I think it’s a simple effort, but it has to be prioritized, and only when individual cancer centers from the community ask for those sorts of resources and partner with academic medical centers or industry while we have this sort of impotence to sort of really affect and help these patients, only then can we make an affect, and again it’s not that difficult and I think that it needs to be an understanding from the industry standpoint, from the folks with money really, and making sure that they have the resources are only, the resources are not only directed to a selected few.

How can we increase access to genetic testing for underserved populations in order to increase their access to clinical trials?

Debyani Chakravarty: I think it goes back to patient navigation, they need to know that this is one option that they have to be unveiled of. If patient communities aren’t able to advocate for themselves, and they don’t have the knowledge or the wear with all to do that efficacy, then they rely entirely on a clinical oncologist who has 10-15 minutes at hand. If there’s a patient navigator who speaks the language, who can communicate clearly to the clinical oncologist, who can appropriately deliver consent in genetic sequencing and make it as streamlined as possible, then we will see an increased genetic sequencing in these populations, but it has to be a priority, it has to be funded for the different medical centers, it has to be the capacity and the infrastructure to be able to do this and you will see that increase in genetic testing. The traditional mode of blaming the sites, blaming the providers, blaming the patients, is one that we are seeing just doesn’t work anymore and isn’t true anymore. They want to unveil themselves to the best medical attention that they want. I mean, it’s a fallacy. So, if we provide them the resources that they need, genetic testing with these underserved communities will obviously go up.

Is there anything else you would like to expand upon?

Debyani Chakravarty: I think we are in a moment of prime opportunity, I think there is an understanding and there is a general sense of we need to be able to do this,  Just because we are serving underserved patients this is not charity, it impacts the entire global community of oncology because when we have a diversified patient population, then we are treating the world of oncology as we see it, so our knowledge increases, the biomarker development sphere increases, and the drug development increases, so it is a catalogue, ya know, sort of, cascade effect. But I see promise in the fact that folks are finally looking, to achieve these tangible milestones to make sure that underserved communities get access to the same medications, and in a way they’re also seeing the sort of benefit from doing that and I think only then can we make tangible change. So I’m very hopeful for the next couple of years.