Curing terminal cancer without treatment options

A large-scale precision medicine project launched through industry-academia-research collaboration ①

Starts KOSMOS2 study for terminal cancer patients... recruits 1,000 people

Searches for optimal drug through NGS analysis and multicenter discussions...breaks down boundaries between hospitals

Provides new treatment opportunities for patients...builds a structure for the virtuous cycle of new drug development through the creation of a genome database

Mr.

 

A, a 60-year-old Korean male patient, was diagnosed with gastric cancer several years ago.

 

After struggling to treat the disease for several years, the hospital told A that there was no other treatment option available for him and that he may not be able to live for more than 6 months.

 

As a last resort, A registered to enroll in the KOSMOS study and was told there was a breast cancer treatment available for the genetic mutation he was found with during genetic testing.

 

The breast cancer drug stayed effective for over a year, and after seeing a significant reduction in tumor size, A left his hospital bed and was able to receive the outpatient treatment he had only dreamed of.

 

The stage has been set to create a Korean-style precision medical ecosystem that can provide personalized treatment opportunities for cancer patients with terminal cancer who no longer have treatment options like Mr.

 

A.

 

A large-scale project involving academic societies, hospitals, research institutes including the Korean Society of Medical Oncology, Korean Cancer Study Group, Korea Health Industry Development Institute, National Cancer Center, Roche Korea, and Lunit Inc.

 

is set to start this year.

 

◆Use without indication or approval ’OK’…brings new hope to terminal cancer patients The clinical project, KOSMOS2(KOrean precision medicine networking group Study of MOlecular profiling guided therapy based genomic alterations in advance Solid tumors II), will be recruiting 1,000 patients for 3 years.

 

Subject patients are those with terminal-stage cancers that have a life expectancy of 6 months or less.

 

In general, these patients are advised to leave the hospital because there is no other drug available for their use in the hospital.

 

Therefore, their caregivers travel from hospital to hospital in search of one that can take care of their beloved’s illness just a little more.

 

When left with no other option, most of them end up receiving hospice care.

 

Enrolling in the KOSMOS2 study could open up new opportunities for these patients.

 

First, patients who enroll in the KOSMOS2 study receive next-generation sequencing (NGS) to check for genetic mutations.

 

Roche Korea provides an NGS-based comprehensive genomic profiling (CGP) Foundation Medicine Service.

 

The results are stored on ‘Navify Tumorboard,’ Roche Diagnostic Korea’s multidisciplinary tumor board (MTBs) that was developed specifically for cancer treatment.

 

It is a multicenter MTB that has been first attempted in the KOSMOS project that allows associated companies to share data.

 

Academic specialists in pathology, oncology, and bioinformatics formed 6 teams to meet twice a week to analyze the patients' mutation status and discuss available drugs and treatment strategies.

 

In the KOSMOS2 study, patients can attempt to be treated with drugs that are not approved in Korea or has no indication for their cancer if the doctors deem the drug appropriate.

 

Therefore, the patient can receive treatment with a new drug that is not normally available, and the drug cost is borne by the pharmaceutical company.

 

Of course, not all patients can receive treatment with new drugs.

 

A drug that targets the patient’s mutation that had been identified through genetic testing has to first exist.

 

The academic society estimated that around 30% of the patients will be able to receive treatment with new drugs.

 

However, in the KOSMOS1 study, which became the basis for the KOSMOS2 study, more patients than expected were provided treatment opportunities.

 

This was an unexpected achievement of precision medicine that even surprised the specialists.

 

◆Organic cooperation for Korean precision medicine...established a system for a virtuous cycle In the KOSMOS2 study, academic societies, research institutes, hospitals, and pharmaceutical companies organically work together to bring out the best results for each patient.

 

The Korean Society of Medical Oncology and the Korean Cancer Study Group will lead the study, developing the specific design for the study and generating clinical and genomic data.

 

As the Ministry of Food and Drug Safety’s designated national cancer data center, the National Cancer Center will be providing the technology and infrastructure required to build an integrated database for precision medicine.

 

The NCC will also select and classify the collected data to provide a high-quality DB.

 

Roche Korea will support pharmaceuticals and the optimal precision medical platform.

 

To promote the project, the Korea Health Industry Development Institute will connect institutions, domestic and foreign pharmaceutical companies, and genome and software companies for collaboration.

 

The first patient was recently enrolled in the KOSMOS2 study, which has been recruiting patients since the second half of last year.

 

The study will enroll patients for 2 years, follow up for 1 year, and conclude the study after 3 years.

 

The KOSMOS2 research project will provide patients with new treatment opportunities, and enable academia to realize precision medicine in the true sense regardless of their affiliation or region.

 

Research institutes and industries can use high-quality genetic DB of cancer patients to conduct new research such as new drug development.

 

In other words, a virtuous cycle of precision medicine and innovative new drug development will be created.

 

Yong-Woo Kim, Lead of the Biopharmaceutical Industry Team at KHIDI, said, “It is important to build an integrated clinical genomic database as the basis for precision medicine and new drug development of pharma and bio companies in Korea.

 

The organic cooperation between the government, academia, hospitals, and companies, will not only bring destructive innovation in precision medicine, but it will also mark the starting point for the revitalization of precision medicine in Korea."