OncoDNA is a Belgian genomic and theranostic company specializing in precision medicine for the treatment of cancer and genetic diseases. I spoke to CEO Bernard Courtieu to hear about the latest advancements in precision medicine and the promise they bring to oncology patients, physicians and researchers.
Please provide some background about yourself and the company.
I’ve been in the life sciences and biotech business for the last 30 years. Since 2007, I have been the CEO of IntegraGen, a French genomics company that was acquired by OncoDNA two years ago to create the new OncoDNA group, which I am now leading.
Nowadays, OncoDNA has a global, concrete footprint in the industry of precision medicine. We are roughly 115 People, with over 14 million euros in revenue last year.
IntegraGen was created in the year 2000, originally as a spinoff from a research entity, where we provided genomics services for both the academic and industrial R&D market, from fundamental research to clinical and applied research.
OncoDNA was founded by Jean-Pol Detiffe in 2012. I’ve known him since 2006. We had discussed joining forces a number of times. We believed that OncoDNA and IntegraGen would complement each other perfectly. Both companies were specializing in the field of precision medicine.
Our activities at IntegraGen were mainly in France and the focus was mostly on researchers, compared to the theranostics orientation of OncoDNA, which had a global presence in over 30 countries. Merging the two made a lot of sense in our view. It took us some years to organize that and we ended up doing it in the form of a friendly takeover.
Now, OncoDNA group is covering the entire value chain from research and drug development, to patient treatment and monitoring. We have a broad network of customers and partners in the largest cancer and research centers in Europe and across the world, including the Dana-Farber Cancer Institute in the United States and the Curie Institute in France, to which we provide genomic services, biomarker tests, as well as data analysis and clinical interpretation support.
What kind of challenges do you solve for your clients?
The two key questions are, how do we manage the complexity of the data, and how do we get financing from the payers to make sure that precision medicine becomes a reality.
The first challenge is the complexity of genomic data. If you sequence the entire genome of a patient, you’re generating roughly 200-300 gigabytes of data, which is equal to 100 Bibles. If you give a clinician the equivalent of a hundred thick books, and give them half an hour to identify where the juicy bits are, you probably won’t get very far.
To outsmart molecular complexity, you need to dig deep into the data and be able to have the right tools to assist the interpretation process. It’s impossible to work with raw data if you ever want to find the value in that huge ocean of data.
We have been developing a number of tools to enable the user, whether it’s a researcher, a clinician or a pharma company, to have a simplified genomic profile of the patient in less than 10 tabs or a couple of pages of reports.
The second thing is financing and access to reimbursement. In most countries, biomarker tests are not reimbursed.. Some countries like Germany, UK and France have implemented initiatives to provide access to precision medicine, but they are still rare.
The access to financing is complicated, which is why industrial research is the way forward. Currently, research is funded by pharma companies or large clinical centers but at some stage, precision medicine will become an absolute necessity for the financing of the treatment.
In general terms, biomarker testing costs a 10th or 100th of the total treatment costs, and it’s probably the least reimbursed or the least financed part of a patient’s journey. The pandemic has highlighted the importance of the diagnostics industry in a number of aspects. Countries and their Social Security insurances should start financing the diagnostics and with it, the ability to provide precision medicine to the wider community.
What are the benefits for the patient?
I think the benefit for the patient is absolutely obvious. We had a number of cases of stage 3 or 4 metastatic cancer patients who had no treatment alternative. We were able to identify alternative treatments and have success stories of patients who are in remission, years after their diagnosis, whereas the traditional standard of care was going towards palliative treatments.
The financial benefit for the payer has to be dramatically underlying because clearly, with the prices of targeted therapies increasing, only rich patients or ones with good insurance will be able to afford it. In reality, only patients with a very specific genomic profile can benefit from these treatments.
Precision medicine saves money twice. First, by avoiding unnecessary treatments for those who wouldn’t benefit from them and secondly, by saving those treatments for those who would benefit from them the most.
What are some treatments or technologies that you find exciting these days?
We are in the middle of a clinical revolution. Things that were completely unthinkable 20 years ago are happening now. For example, 25 years ago, it was an absolute certainty that someone with a malignant melanoma had a three-year survival expectancy. Today, more than 50% of patients who survive those years.
The other potential revolution is the ability to deploy and democratize genomics. 10 years ago, you had to have fresh frozen tumor tissue to be able to sequence in certain quantities. Today, any two milliliters of blood, urine, or saliva can be used to extract the cell-free DNA, sequence it and identify the tumor from the rest of the cells.
Lung cancer is usually not a mass but a number of scattered tumors, so it’s difficult to remove with surgery. Moreover, having lung surgery is extremely violent and debilitating for the patient. You only do that once because the medical cost and impact for the patients is huge.
Liquid biopsy is another revolution that gives access to monitoring the disease and identifying relapse early. Drawing some blood from a patient’s arm is something that you can do regularly to closely monitor response to treatment. We are talking about a revolution in Patient Management. That’s exactly what’s been happening every year for the last 10 years.
What are your future plans for OncoDNA?
Personalized vaccines. It’s interesting that a number of companies including Moderna and BioNTech have been working on mRNA vaccines for the last 10 years. The entire world was saying that this might be the technology of the future, but it might just remain in the future. Obviously they have demonstrated extremely well that this technology is an outstanding way to provide an immune response.
At the same time, one of the revolutions in treatment is immune oncology, which is the boosting of lymphocytes to attack cancer cells. The idea is to sequence the tumor and prepare a personalized vaccine, especially designed for the specific characteristics of the tumor of the patient.
Essentially, we’d be vaccinating the patient against their own cancer. Mutated genes can be identified by the lymphocytes. The issue is that it’s never a single protein that’s mutated but a number of them. In order to be identified, tumors need to have a significant mutational burden. Rather than boosting every lymphocyte on every cell that looks a bit different, which is the current standard practice, personalized vaccines will provide guiding missiles that you can use to target specific cells that have the mutated proteins on their envelope. That would be complementary to the drugs, but also provide a boost of 10, 100 or 1000 factors because the lymphocytes will be attracted to the cancer cells and attack them specifically. That would be another step towards the eradication of cancer.
We’re still far from proof of concept, but we have a few very exciting aspects on that and on the ability of providing not only immuno oncology drugs that boost the lymphocytes, but also injecting a vaccine to a patient so that the lymphocytes can identify the specific cells that need to be targeted. That will be an absolute revolution and it’s one of the very exciting developments that we have.