To mark World Cancer Day, PharmaTimes talks to Janssen’s Biljana Naumovic about the current landscape in oncology

What is your background and current role?

I’m a medical doctor by training and started my work in the pharmaceutical industry in 2002 at Roche, where I took on various positions from commercial through to medical affairs. I joined Janssen as vice president commercial strategy leader for Oncology for Europe, Middle East & Africa in early 2019 from the position of vice president of the Commercial European organisation for AstraZeneca.

What does your day-to-day work involve?

There is no typical day as each day brings new challenges and complexities. A key role is overseeing the implementation of long-term strategies for Janssen in oncology. I’m also responsible for building partnerships for projects that will pioneer the future of healthcare, as well as navigating the complexities surrounding it.

Why the interest in cancer?

Despite the fantastic progress made across Europe over the last decade, cancer is still responsible for one in four deaths and remains the second leading cause of premature death. These statistics highlight how cancer can affect so many of us, whether directly or through family and friends. On a personal level, I have witnessed the impact of cancer and through my work I hope to leave a legacy that ensures other generations do not have to experience the same.

It would be incredible to play a part in defining a new era of cancer treatment – I’d particularly like to see more treatment advances in solid tumours which, according to the World Health Organisation’s 2018 incidence statistics, represent a quarter of all new annual cancer cases and is an area where I believe we can have a profound impact. This keeps me running every single day towards that goal.

Do you believe we will ever be able to cure all cancers?

I wouldn’t do what I do if I didn’t think we could cure cancer!

We make important strides every day and the recent Comparator Report on Cancer in Europe 2019 by The Swedish Institute for Health Economics (IHE) reiterates that, although more people are being diagnosed with cancer, the improvements in services and treatments are leading to better outcomes. I am proud to be a part of an organisation which is contributing to these improved outcomes.

If we continue to invest in oncology, we will enable those affected by cancer to secure everyday individual Victories Over Cancer and enjoy more of life’s meaningful moments. I’m confident that these victories will bring us closer to a cure.

What have been the key successes in the fight against the disease in recent years?

Over the past decade, we have seen huge advances in cutting-edge research which helps to further increase our understanding of cancer and how it develops. We have also seen the rise of CAR-T therapies to immuno-oncology combinations and vector-derived gene modification which harness the body’s systems to help fight the cancer. These have immensely changed how we look at cancer and will certainly help springboard research and development over the next decade.

What’s in store for cancer research in 2020?

I believe there are three things that will be the focus of cancer research in 2020. These include:

Progress in novel pathways and the use of targeted therapies in disease areas where they don’t already exist. Importantly, this will abandon the ‘one-size fits all’ approach to cancer research and development;

Looking at how we expand the use of CAR-T therapies, specifically in solid tumours where this hasn’t previously been a focus; and

Advances in disease interception – instead of waiting to treat people once they become ill, we can now treat individuals earlier, providing new ways to diagnose and stop cancer before it can spread.

What do you think could have the most impact on improving cancer survival?

There are several things I believe will have the greatest impact on improving cancer survival, these include:

Early detection. The earlier we can detect the cancer, the better chance we have at finding a successful treatment;

Early intervention. The earlier that we can intervene in the disease pathway, the better the chance we have at prolonging survival; and

Unleashing our own body’s potential. Activating the power of the immune system to allow our bodies to fight against the disease is already having a significant impact on cancer survival.

Of course, with improved survival comes other important factors which need to be considered when supporting patients. The psychological impact can be profound, so it is crucial to ensure holistic support is in place to address both physical and mental impacts of cancer.

What are the key challenges in cancer research?

One of the key challenges in cancer research is the speed at which we bring research to life. If we want to intercept the disease as early as possible, we are sometimes unable to do this when using conventional endpoints, such as overall survival, which can take a long time to achieve. We need to adapt so we can grant patients faster access to potentially life-saving therapies – adopting a more innovative approach to research, such as using novel endpoints in research. Prostate cancer is one example where metastasis-free survival has been used as a clinical endpoint. By doing so, patients with non-metastatic castration-resistant prostate cancer were granted faster access to an important medicine that helps delay progression to metastatic stage disease – a crucial goal in prostate cancer treatment.

In addition, we need to understand how cancer becomes resistant to therapy as some patients will eventually stop responding to treatment. We are also presented with the challenge of identifying more targeted and individualised medicines, particularly where prognosis for patients is very poor and high unmet need remains. Advances are being made in this area, for example in bladder cancer where the FGFR pathway has been identified as an important target for some patients who are less responsive to existing treatments.

Is there still as much of an appetite among pharma to develop new cancer treatments?

We are aiming to make cancer a manageable, even curable, condition. We cannot underestimate the work still to be done and the threat that remains. According to the IHE report, cancer may soon overtake cardiovascular disease as the leading cause of death in Europe and this is already the case in some countries across Europe, including the UK, France and Spain.

We must therefore continue to deliver medicines where patient needs are greatest. Every day, the research conducted by incredibly talented people across Europe brings us closer to identifying treatments with potential to revolutionise patient outcomes. It’s a very exciting time for oncology, and I’m proud to be playing my part.

How can we best reduce the global impact of the disease?

Further awareness on symptoms to lead to earlier detection and diagnosis is important for reducing global impact. Alongside this, empowering patients to actively manage their disease and equipping them with the appropriate tools allows them to feel better-informed to have discussions with their HCPs.

What is the most important message about cancer to get across to the public?

The most important thing an individual can do is prevention. There are several clearly identified risk factors we do to ourselves that are adding to the risk of cancer development. Four most prominent ones are smoking, inappropriate diets, lack of physical activity and lack of vaccination against preventable infectious agents. We need to step up here and change!

On top of that of huge importance is knowing the signs and symptoms in order to identify the cancer at earlier stages of disease, and importantly before it has spread. By doing so, patients can be treated earlier, leading to prolonged survival. Achieving this is what makes my work so worthwhile. Knowing that the advances being made in oncology can transform the lives of patients and their families. This is the legacy I hope to leave.