As an oncologist, you’ve fought cancer for almost three decades now. What has changed in this time?
The profession has become much more technical, which in turn requires doctors to become a specialist for a certain type of cancer. Our understanding of cancer has improved significantly, but this also means that staying on top of current developments has become a challenge. The days when you could just attend a conference every second year are definitely over. Now you have to get informed about new developments on a daily basis.

But in their daily work, oncologists can rely on medical guidelines that tell them how to treat a given cancer, right?
Sometimes it’s quite regrettable that they do. The guidelines are primarily written from a viewpoint of what medications are reimbursed. They do not explore all possibilities that make sense from a medical point of view. It is quite common that the treatments that are mentioned fail, because of biological reasons. So it often happens that oncologists will tell patients: “I did everything I could” when they’ve exhausted the options mentioned by the guidelines. But in reality, there are other treatments that could help, they’re simply not aware of them.

How can one become aware of these alternatives?
A combination of diagnostic tests and therapeutic products can help. I’ve been working with OncoDNA’s test since about 2014. I see maybe a hundred patients per week and use OncoDNA’s test several times every week to get a clearer picture of the cancer and the therapeutic possibilities.

And does this test make a difference?
Yes. I have several examples where it allowed me to identify precisely targeted therapeutic approaches that helped patients who otherwise would have had just a very short life expectancy. One case that is the perfect example is a woman of 40 years that had breast cancer. After 5 years of trying out different medications, all possibilities were seemingly exhausted. And still, I ordered a test from OncoDNA and it identified a certain mutation of the cancer (mutation AKT1 on blood sample). The report that came with the test results stated that Ipatasertib might be effective in this case. But this drug candidate from Roche is still in clinical trials and wasn’t available in France and especially for that women. So I applied with the authorities for a temporary authorization to prescribe it, which was granted (and she was the first women in the world receiving this treatment out of a trial) . It had immediate effect and improved the patient’s quality of life substantially, eliminating the pain from which she was suffering as well: she is still going well 1 year after !

But I imagine that not every patient has a form of cancer with a specific mutation that responds well to drugs still in development.
No, but even in standard situations where I might have several treatment options, this test can clearly show which will ones will be efficient and should be tried first, and which ones will not help and are a waste of time. And in cases in which the test report specifies that there is no treatment option at all, at least I have this certainty, which allows me to address the patient and the family accordingly.

Since OncoDNA’s test is fairly new, it isn’t yet reimbursed in all healthcare systems. In France, patients have to pay the cost of several thousand Euros themselves. Does this pose a problem?
Many doctors are still reluctant to propose such a test. It is a difficult conversation to have with the patient. But I’m confident that this will change in the future and it will be reimbursed. In the meantime, we have established a solidary system here, a communal savings pot that helps patients that cannot afford to pay for the test.