Genomics is rapidly driving changes in the field of oncology, particularly the way in which cancer is diagnosed, treated, and monitored. Garret Hampton, Executive Vice President of Illumina’s Clinical Genomics Group, shares his vision for Illumina’s critical role in the ecosystem that fuels new discoveries, therapies, and cancer management insights.
Coming from a pharmaceutical development background, what do you see as Illumina’s biggest opportunity to impact the future of oncology?
Just before I joined Illumina, I spent several years at Genentech where we focused on developing transformative medicines in many areas of human disease, especially for cancer. However, transformative therapies are only transformative for the right patients. From therapies that target specific aberrations in the cancer genome, to immunotherapies that unlock the immune system’s ability to kill cancer cells, next-generation sequencing (NGS) is playing an increasingly important role in selecting the right therapies for the right patients.
While the primary goal is, of course, to enable patients to receive a beneficial treatment, these NGS diagnostic tools will ultimately help global health systems manage their costs and bring beneficial drugs to more patients. A rally call to embrace these imperatives will make a true, lasting impact on cancer and other devastating illnesses.
What is Illumina’s vision for how NGS will be used in clinical oncology?
Simply stated, our vision is to drive comprehensive NGS testing as standard of care in clinical practice. Although there are many points along a patient’s journey in which NGS will be beneficial, we believe that tests to inform which drug a patient should receive, as well as tests that can monitor whether the patient has benefited from the drug and if the cancer is under control or returning, will be of significant impact in the next few years. One of the key advantages of NGS is that it enables a comprehensive profile of a patient’s tumor, opening up the possibility of matching them with the right drug. One of the most transformative areas of cancer treatment is immunotherapy, the goal of which is to reactive the patient’s own immune system to attack cancer. The biology is very complex, but it turns out that DNA and RNA sequencing is highly informative in predicting which of these immunotherapies will work in subsets of patients. In the long term, the ability to use NGS to identify cancers early – before the signs and symptoms become evident – will be truly revolutionary, increasing the likelihood that surgery, radiation and therapies will be more beneficial. Companies such as GRAIL are using our technologies to see if this is possible. Ultimately, our objective is that ultimately every cancer patient have access to genomic testing, and we view our partners as a key avenue to achieving that goal.
What solutions is Illumina developing to support industry stakeholders and partners?
Illumina is the leading provider of innovative genomic sequencing systems, products, and services to support significant discoveries in cancer. The next stage of our evolution is to provide clinical solutions that will support diagnosis, therapeutic selection, and monitoring. It begins with securing regulatory authorization for our instruments, such as the MiSeqDx® sequencer, but also includes the creation of, and regulatory authorization for, companion or standalone diagnostics, as well as open assay systems, which will allow our partners to develop their own companion diagnostics on a common platform.
With the launch of TruSight® Tumor 170, a novel DNA- and RNA-based solution to provide comprehensive variant analysis for solid tumors, we developed the underlying chemistry and workflow to enable a modular and scalable approach to future IVD development in tissue and blood. This platform, called TruSight Oncology, provides the building blocks for future products in our pipeline. This chemistry platform can be extended to whole exome and genome sequencing, as well as sequencing RNA transcripts for truly comprehensive profiling of cancers. We believe that TruSight Oncology will be highly impactful, especially in enabling the development of immunotherapy and ctDNA monitoring applications.
Are there indications that the market is moving to clinical whole exome and whole genome sequencing in the near future? What would that entail?
Key drivers of the use of whole exomes will be immuno-oncology and liquid biopsies. Both of these emerging applications require high-capacity exome and genome sequencing and bioinformatics interpretation to extract the key features of a tumor that can be used to develop new concepts for treatment and management. These applications will ultimately be enabled by Illumina’s next-generation platforms such as the NovaSeq™ Series. There are also indicators that the demand for clinical whole genome is increasing; for example, our work enabling initiatives like the Genomics England, 100,000 Genomes Project (GEL) is demonstrating how whole genome sequencing of tumor/normal samples can provide information that is not captured by targeted, or even whole exomes.
What are some of the initiatives that you are most excited about?
A very exciting development is the fact that many of the world’s largest economies have committed to national-scale sequencing to support precision medicine initiatives, as well as demonstrating the value of sequencing to their health systems, efforts in which we are playing a leading role. It is exciting to see how genomics is having an impact at the population level and more governments and health systems investing in studies like GEL to drive discovery and guide policy.
At the end of the day, like many patients, physicians and colleagues, I am really excited to see the extent to which NGS will impact cancer care, as well as diseases that affect the human condition. Looking out over the 10-, 15- and 20-year horizon, it is reasonable to expect that NGS will play a fundamental role in many aspects of our lives, including the diagnosis and treatment of patients with life-threatening diseases.
The possibilities for Illumina to impact the human condition are truly remarkable.