An interview with Mark Wildgust, VP, Global Medical Affairs, Oncology, Janssen conducted by April Cashin-Garbutt, MA (Cantab)
What is the vision behind the Victories over Cancer initiative?
Victories Over Cancer is about enabling those affected by cancer to enjoy more of life’s meaning full moments and making cancer more manageable. At Janssen, we're really thinking about the elimination of cancer, and we take a very deliberate approach to that.
Victories Over Cancer depicts what we're trying to do as a company, which is focusing on cancer types and sub-types which we know best, leveraging our expertise by looking at creating curative regimens and disease interceptions, using diagnostics to help optimize therapy and using novel medical science.
Victories Over Cancer is our way of talking about that vision and mission that we have as a company in terms of what we're doing to help shape cancer therapy today.
How do you hope to change expectations of what a cancer diagnosis means?
We're looking towards hope. We’re looking towards changing a cancer diagnosis from worry and palliation, towards long term durable control of cancer and ultimately looking at elimination of the disease. We’re trying to go one step further, stopping cancer before it can get a hold in the body, a process known as cancer interception, and we're trying to create profound outcomes.
A cancer diagnosis today is very impactful for patients and for families. But we're trying to change that. We're trying to change that towards saying, "Look, we can control disease. We can eliminate it. We can look towards cure."
One good example of that is the recent studies that we just presented at ASCO in the New England Journal of Medicine in prostate cancer, where we used a prostate cancer drug and ADT, intervening really early in therapy, and we saw a profound improvement in overall survival.
That's a good example of trying to intervene earlier, trying to improve more hope, and trying to really control disease. We’re trying to change that cancer diagnosis from worry, to hope, to improving lives and eventually cure.
Can you please outline the Make Blood Cancer Visible initiative?
When you think about blood cancers, people often think of one homogenous type of disease. But blood cancer is actually made up of almost 140 different types.
Some of those are very rare, some of those are life threatening, many of those go unnoticed by the general public, and can cause patients to feel alone. They don't feel like people understand their disease, they feel somewhat unsupported.
So part of what we're trying to do with Make Blood Cancer Visible is to talk to people who are impacted by blood cancer, to really make that more visible by sharing real, visual images and talking about the stories of the people who have been affected.
What progress has been made so far?
We launched a video on the Facebook page talking about patients’ struggle with blood cancer. That video is there to inspire patients, and friends and families, and carers, about the overlooked impact of blood cancer. There’s now a great collection of stories shared there from around the world.
The team has also hosted its first Blood Cancer Policy Summit and there are more things that the team is planning in terms of the upcoming Blood Cancer Awareness Month in September as well.
How are Janssen addressing unmet needs?
Our way of addressing unmet needs is thinking about ultimately what are we trying to do? We're looking towards curing cancer, and we're very focused on that.
For us, it is really about focusing on specific areas that we have deep expertise and knowledge in which include haematological malignancies, prostate cancer and lung cancer, looking towards curative regimens and cancer interception.
We’re also looking to understand the biology of cancer so that we can then use diagnostics to help guide that, and bring innovative therapies to cancer patients to really try to improve outcomes.
I think it is about understanding cancer, trying to understand the goals which, fundamentally, are elimination and cure, and then really matching that with innovative therapies to try to advance care.
Can you please explain how you are working with the HARMONY initiative and Yale School of Medicine to harness knowledge from big data and share with others?
At Janssen, we do a tremendous amount of research. In 2014, we decided as a company that we wanted to try to find a way to be able to facilitate sharing of the huge amount of data that we have as a company.
Many times we get asked lots of questions, so the YODA initiative that we put forward with Yale School of Medicine was really about providing open access to the data that we have, to facilitate the sharing of that data. I think at the time, we were the first company to go about doing that.
We collaborated with the Yale School of Medicine to have a third, independent party, be able to take a look at those questions that people were asking us, and then make a decision in terms of sharing that clinical data. The idea was that people who do have questions could access our data and answer their questions. So rather than it just sitting with Janssen, it really gives the ability for different groups, and institutions, and researchers to leverage that data to help better ask and answer questions they may have. And that's broad, across our entire pharmaceutical sector, it's not just necessarily oncology and hematology.
Now HARMONY's a little different. It's really a public/private partnership, with the patient at the center. HARMONY is about trying to understand human metalogic malignancies, trying to understand unmet needs, and how we can treat those patients more effectively.
What we're trying to do is harness big data to provide a way of trying to understand the diseases more completely so that we can try to understand current outcomes with therapy, and then that will allow us to think about what are the right ways to treat them and measure improvements in care.
Are there new ways in which we can measure outcomes, and look at relevant research questions? So, a little different, but at the heart of it, it's about leveraging data to try to improve care for patients.
How far away is personalized cancer care?
Personalized cancer care is here today. I mentioned at the beginning that we're using diagnostics to help guide therapy decisions today, and I think across oncology that it is here.
We've had targeted therapies for a couple of decades. I think what we are starting to see is more and more of those. But personalized cancer therapy is really about understanding the biology, leveraging diagnostics, and if we can understand the specific biology of the tumor then we can treat it with the right regimen for that specific tumor.
We have some examples already in our portfolio, for example a targeted BTK inhibitor. What we see when we use something like these targeted drugs in Chronic Lymphocytic Leukemia (CLL), is that a targeted therapy is improving survival in all different types of patients with CLL, whether those are patients who have treatment naïve CLL, whether those people have had relapse disease or high risk disease, that targeted approach is improving outcomes in CLL.
We have a very, very large trial ongoing in an aggressive type of lymphoma called diffuse large B cell, where we're specifically using a biomarker in a personalized cancer approach to try to identify those patients who have the worst outcome, but we also know that our drug biologically works better in those patients, in those what we call non-GCB patients. We're leveraging a diagnostic to identify those patients who we know have the worst outcome but where we think our drug can work in the best way to try to improve therapy.
So personalized cancer care is here. We're using it today with our drugs and we also have compounds in our pipeline such as parp inhibitors, looking at DNA repair abnormalities in prostate cancer. We are also looking at FTFR alterations in urethral cancer, or lung cancer. We're already using it today here at Janssen, and I think that the more we can understand the biology, the more we can personalize cancer care to really get the right treatment for the right tumor at the right time.
Are more vaccines to prevent cancer in the pipeline?
The simple answer is yes. A lot of companies have been exploring cancer vaccines for many years. But I think sometimes there's a misnomer in the public.
Cancer vaccines aren't like getting the MMR vaccine that we all get as a child, or a TB vaccine, where we think about using a vaccine to prevent that childhood disease. The idea of cancer vaccines is a way to try to present our immune system with that tumor antigen, where then our own immune system can see that tumor antigen as foreign, and then we can harness the immune system to tackle that cancer.
Cancer vaccines are one way in which we can harness the immune system to engage and tackle cancer today. At Janssen Oncology, we already have cancer vaccines in the clinic. We have two of them, and we have more to come. We think about cancer vaccines as part of our approach for immuno-oncology.
We think about immuno-oncology, we think about cancer vaccines, which is this whole idea of tumor antigen presentation, but we also think about other things too in terms of harnessing the immune system.
In a similar concept to vaccines but a slightly different procedure, we're looking at trying to modulate our own T cells, our immune checkpoint inhibitors. We're trying to modulate the tumor immune response by targeting these immune suppressive cells, and then we're also looking to find ways in which we can get T cells to tumors, which is a part of our immune system to be able to tackle the cancer as well.
Vaccines are one part of the approach in terms of harnessing the immune system. There is promise here and I think it is one arrow in your quiver to try to tackle cancer. It is part of our strategy towards immuno-oncology, and trying to look towards the elimination of cancer and ultimately a cure.
What do you think the future holds for oncology treatments?
I think it truly is hope. We’ve made progress and in the history of cancer therapy we've gone from chemotherapy to targeted therapies to immuno-oncology, and I think we're at that place today, that as a company, again we're focused on the elimination of cancer and ultimately a cure. Taking a very deliberate and thoughtful approach in terms of that being our mission. Our close partnership with academia, and with other companies, with other outside stakeholders, we have a clear vision looking towards curing certain types of cancer.
The future is bright. We're leveraging science and biology to help guide us. We're very much focused on making sure we have the right disease expertise so that we can understand the disease, then we can really try to create the right type of portfolio for curative regimens, and then, as we talked about before, using diagnostics and innovative therapies to try to advance care.
The future holds a lot of hope and companies like ourselves are leading that effort that and we see that today. We see that some of the drugs we have already developed are controlling disease and significantly improving survival in patients. When we look at the data we just presented in prostate cancer at ASCO, and in the New England Journal of Medicine, our developments are significantly improving survival.
Other compounds that we have developed, have been seen to significantly improve care for patients with multiple myeloma, and we've only just started with that. In our pipeline, we have other compounds, again where we're looking to intercept disease earlier to try to improve outcomes for these patients.
What are the next steps for Janssen?
Janssen is focused on innovation. I think people tend to see biotech companies as ones that are leading innovation, and Janssen truly are at the leading front of innovation.
I talked about immuno-oncology, that's the next wave of cancer therapy, and think sometimes people don't recognize where we are in terms of what we're doing. We already have ten immuno-oncology compounds in the clinic today that are already bringing benefit for patients. This includes compounds for CLL, myeloma, prostate cancer, and we have more in the pipeline that we're trying to bring forward quickly so that patients can realize our vision of hope and enjoy more of life’s meaningful moments.
We're looking to make fundamental strides forward in terms of advancing care, we're focused on survival, we're focused on intervening earlier. We have therapies here today that are already bringing benefit to patients.
Janssen’s vision is very clear, we're looking towards cure and we take it very seriously. Janssen has been around a long time. We're an innovation based company, and our focus is on bringing innovative therapies forward. We have a track record of doing that with great compounds, and we're going to keep doing it.
Where can readers find more information?
About Mark Wildgust
Mark Wildgust has spent almost 20 years in the pharmaceutical industry working primarily in oncology, hematology and virology. He completed his undergraduate degree at the University of Plymouth, UK, in Biological Sciences and his PhD in Trace Metal Toxicology at the University of Manchester, UK.
He then spent a short time as a post-doctoral researcher at the University of Maryland in the United States.
After leaving academia Mark has worked for Bristol Myers Squibb, Pfizer and Janssen. Mark has been at Janssen for more 10 years.
Across his career he has predominantly spent his time in leading the development of medical compound strategies, working closely with academic investigators and scientists along with R&D teams focusing on innovative research towards transforming outcomes for patients. Mark is the Vice President of Global Medical Affairs, Oncology, at Janssen, based in the United States.