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Exclusive R&D interview: David Fredrickson

David Fredrickson

In an interview in Nordic Life Science, the Head of AstraZeneca’s Oncology Business unit, shared his insights on current drug development within oncology and how we can create faster access to innovative medicines.

“Drug development within oncology has evolved to become more flexible,” said David Fredrickson, head of AstraZeneca’s oncology business unit.

“Clinical trials with adaptive design are becoming the norm, enabling the inclusion of new cohorts of patients or the introduction of new, relevant clinical end-points. This is essential to match the pace of scientific knowledge in oncology, where the traditional order of Phase 1, 2 and 3 trials in drug development can be turned upside down, and development can be shortened based on relevant scientific insights.”

It is essential to maximize the potential of big data

Big data, which must be analyzed computationally to reveal patterns, trends and associations, are increasingly a key factor in developing cancer treatments, notes Fredrickson.

“We’re seeing the convergence of science and data analytics. In a context where scientific knowledge progresses quickly, it is essential to maximize the potential of big data and technology to confirm early trends, or to complete our research efforts with real world evidence.”

Cancer is a heterogeneous disease

New insights continue to shape research. Just 10-to-15 years ago, lung cancer was considered a single, homogeneous disease.

“But lung cancer is incredibly heterogeneous and not just a disease that effects smokers,” according to Fredrickson. “We want to make sure we’re leveraging the science to find out what drives the disease so that we can offer personalized treatments.”

Because cancer is a heterogeneous disease, precision treatments are critical.

“If you can identify the right biological target and select patients with susceptibility to the target, you can improve efficacy and reduce side effects.”

“If you can identify the right biological target and select patients with susceptibility to the target, you can improve efficacy and reduce side effects,” he added. “We are continuing to see and learn the importance of finding and delivering the right drug for the right patient at the right time.”

Earlier diagnosis improves survival rates

Along with efforts on new treatments, improving earlier diagnosis is also key.

“In oncology, we know the best outcomes occur when we can diagnose and treat patients early,” Fredrickson said.

Screening rates for lung cancer globally remain low, adding to the challenge of early treatment.

“Stage 4 lung cancer has a very low five-year survival rate, between 5 and 10 percent. If we can diagnose the disease earlier, physicians can suggest treatments with curative promise and improve survival rates dramatically.”

How do we combine them?

Combining complementary drugs also is showing great promise.

“As different combinations may benefit patients differently, the difficulty lies in assessing and determining the right potential permutations. In a very competitive environment, it’s important to identify early which combinations have the best chance of working,” he said.

This is particularly true in the field of immuno-oncology, which uses drugs to help the body’s natural defenses fight cancer.

“We’ve seen remarkable results with the first generation of immune-therapies.”

“We’ve seen remarkable results with the first generation of immune-therapies. The question is: How do we combine them with other treatment modalities to get better results,” said Fredrickson.

Critical dialogue needs to happen

The Nordic countries have many strengths when it comes to oncology research, including an emphasis on personalized medicine, Fredrickson noted.

“The testing rates are higher in the Nordics than in many other countries.”

“The testing rates are higher in the Nordics than in many other countries as there is a real focus on ensuring patients get tested and treated with the right medicine,” he said. “And although there is a willingness to introduce innovative medicines as rapidly as possible, recently, as medicines are getting to market quicker, often with limited data sets, there has been an increasingly conservative approach to achieving reimbursement for these medicines.”

Noted Fredrickson: “Critical dialogue needs to happen; we need to create access to innovative medicine as soon as possible because patients are waiting for them, and at the same time we need to discuss solutions that enable recognition of the value of the medicine based on clinical criteria that continue to evolve.”

Optimistic about the future

For its part, AstraZeneca made a commitment at the start of 2014 to launch six new oncology medications by 2020, Fredrickson said. With four already launched, Fredrickson thinks the company can meet that goal.

He also is optimistic about AstraZeneca’s efforts to eliminate cancer as a cause of death.

“The future is about combining what has already been proven to work – screening patients at risk and diagnosing cancer at stages where a cure is still possible; delivering treatments with curative promise and overcoming emerging resistance by exploring combinations early enough – then we should see sustainable responses and long-term survival.”