Cancer expert calls for closer academy-industry ties to develop new drugs

The National Cancer Center (NCC) needs to play a more significant role in treating cancer and developing new therapies by, for instance, approaching closer to the industrial community if necessary.

Bang Yung-jue, a professor emeritus at the Seoul National University College of Medicine, made these and other points at a conference to celebrate the 20th anniversary of NCC on Monday.

Bang Yung-jue, professor emeritus at Seoul National University College of Medicine, called for closer cooperation between academia and industry to better treat cancer patients and develop new therapies at a conference to celebrate the 20th anniversary of the National Cancer Center on Monday.

"Looking back the past 20 years, new drug development has been rather sluggish, not as great as expected. I think one of the reasons was the NCC keeping distance from the pharmaceutical industry," Bang said. "To treat cancer patients, I believe we will have to work with anyone except evil-minded ones."

Bang pointed out that the U.S. National Cancer Institute, the National Cancer Center Japan, and the European Organization for Research and Treatment of Cancer do not stay away from the industry but rather collaborate in various forms.

He stressed that NCC should give up on the thoughts that it should remain a distance from the industry and open up for cooperation to play the role like other nations' cancer institutes.

"Everyone considers NCC as a leader in domestic cancer studies, and the leader is usually more tolerable and flexible and runs to makes all works go smooth and head to a certain vision," Bang said. "NCC has been working hard even under difficult circumstances, and I hope the center to develop further in the next coming 20 years through closer cooperation with various other communities.”

The SNU honorary professor said cancer drug developments would focus on targeted therapy and immune therapy.

"I believe the development of targeted therapeutics and the subdivision of precision medicine will continue, and the use of cancer immune therapies will also gradually expand," he said.

Bang explained that about 4,400 studies on PD-1/PD-L1 Ab clinical trials were going on as of September 2020.

Particularly, the Imbrave150 trial showed significantly better overall survival and progression-free survival outcomes in patients with hepatocellular carcinoma with atezolizumab plus bevacizumab than sorafenib. With the significant results, the combination therapy is used as a first-line treatment in the study, Bang said.

He noted that Imatinib, an oral anticancer drug developed in 2001 with few side effects, marked a turning point in rewriting the history of targeted anticancer drugs. After the development in 2001, several other targeted therapies were introduced and changed the concept of precision medicine to take hold until now.

"Another revolutionary event happened 10 years later in the form of immunotherapy, and as our understanding of the cancer immunity-cycle deepened, we found immune checkpoint molecules, including PD-1 and PD-L1, and began researches on the antibody," he said.

The professor pointed out that the U.S. Food and Drug Administration first approved ipilimumab for melanoma on May 28, 2011. In 2014, immunotherapy drugs, such as pembrolizumab and nivolumab were developed, and doctors now hope these immunotherapies can cure cancers in the future.

Eom Hyun-seok, director of the Center for Hematologic Malignancy at National Cancer Center, introduced NCC’s accomplishments over the past two decades, including their latest development during the same conference.

Introducing NCC’s recent accomplishments, Eom Hyun-seok, director of the Center for Hematologic Malignancy at NCC, said that the center has focused on clinical trials and developing advanced treatments. More than 100 clinical studies have been reviewed by its institutional review board (IRB) every year.

NCC's neuro-oncology clinic has been leading the studies and treatment of leptomeningeal metastasis in rare and intractable cancer cases. In addition, the musculoskeletal oncology division has been performing bone tumor surgery using three-dimensional printing technology since 2016. Director Eom said the Oral Oncology Clinic has also worked hard to systematize oral cancer microsurgery and restore long-term survivors' function.

For treating lung cancers, NCC has performed more than 8,600 cases of endobronchial ultrasound guided-transbronchial needle aspiration (EBUS-TBNA) since the introduction in 2005, and researchers continued to devise new treatment methods through multiple clinical trials.

Eom added that a study used the Iressa (ingredient: gefitinib) as a first-line targeted treatment for non-smoking patients with lung adenocarcinoma for the first time in Korea and proved the efficacy of therapy combined with a platinum-based anticancer drug and diabetes drug metformin in lung cancer.

He also proposed a new treatment by analyzing global clinical trials to overcome resistance in lung adenocarcinoma patients who showed Tagrisso-resistant.

According to Eom, NCC is developing a diagnostic method to screen for lung cancer based on blood using new technology and tracing the cause of resistance, with a way to predict therapy and toxicity via pharmacogenomics.

In liver cancer patients, the cancer center first identified the near-field therapeutic effect of proton therapy in recurrent hepatocellular carcinoma in the world.

"We expect proton therapy to be reflected in global guidelines for treating liver cancer patients in the future as the efficacy has been proven in phase 3 clinical trials comparing it to the existing standard therapy, high radiofrequency ablation," Eom said. "NCC and seven general tertiary hospitals are building the first large-scale artificial-intelligence data set in Korea with more than 300,000 high-quality liver, gallbladder, and pancreatic cancer cases and allow the development of various AI services."

Since the establishment, NCC also found that screening thyroid cancer was not very effective and published the results in an international thyroid journal. It proved that non-surgical active surveillance in early-stage to be effective compared to the standard surgical treatment, Eom said.

In the study, the active surveillance group showed better physical and psychological outcomes than those who underwent operations for thyroid cancer.

Eom added that the cancer center also found a genome region vulnerable to developing thyroid cancers in Koreans. In addition, researchers also discovered highly related genes and nucleotide polymorphisms and confirmed the genetic characteristics of Asians having thyroid cancer.

"We plan to present a standard for cancer treatment by leading the cancer hospital models as a specialized cancer management institution at the national level, performing the role of a national center for clinical trials, and installing and operating more infectious treatment wards for cancer patients," Eom said.