Could we be on our way to eliminating cancer for good?
What once seemed like an out-of-reach goal may soon be within our grasp. Take an in-depth look at how Johnson & Johnson is working toward its vision of helping create a world without cancer.
Since 1991, cancer death rates have declined by 33% in the U.S. This encouraging news is due to advances in modern medicine and increased awareness, but there is still work to be done. Cancer remains a leading cause of death globally, and people from underserved and underrepresented backgrounds are more likely to have worse outcomes.
That’s why, for the past 30 years, Johnson & Johnson has been working relentlessly to progress innovative approaches and treatment options, while building awareness to ensure everyone, everywhere has access to care.
“Our vision is to eliminate cancer,” explains Craig Tendler, M.D., Vice President Oncology, Clinical Development, Diagnostics and Global Medical Affairs at Johnson & Johnson. “The best way to do that is to focus on earlier stage disease, which means improving the tools we have for diagnosis or creating new treatments that can be used early on to treat or intercept the disease before it becomes incurable.”
And the company is hard at work. Back in October 2023, Johnson & Johnson presented new research in lung, bladder and prostate cancers at the European Society for Medical Oncology Annual Meeting and in multiple myeloma, B-cell malignancies and myeloid malignancies at the American Society of Hematology Annual Meeting in December 2023. Both meetings showcased innovation and progress in advancing science and novel treatments, with a focus on improving outcomes for—and the lives of—patients who are facing these complex cancers.
Here’s a close look at exactly how Johnson & Johnson is working toward its mission to get in front of—and ultimately eliminate—the disease.
As Dr. Tendler explains, the best way to work toward curing cancer is by focusing on early interventions, when the disease is more localized.
One example: the company’s work in multiple myeloma, a rare form of blood cancer in which plasma cells develop a mutation that causes them to grow uncontrolled and take over the bone marrow.
A small portion of people with multiple myeloma have something called “smoldering myeloma,” a precancerous condition that alters certain proteins in the blood but doesn’t yet cause clinical symptoms. “One out of every 10 of these patients will go on to develop multiple myeloma in the following 12 months,” explains Jordan Schecter, M.D., Vice President of the Multiple Myeloma Disease Group, Johnson & Johnson.
“The standard of care now is to observe patients with smoldering myeloma rather than treat them proactively,” explains Dr. Schecter. “That may mean that a patient ends up hospitalized due to multiple myeloma symptoms before they can even start treatment. The hope is to identify and treat patients with smoldering myeloma earlier to prevent them from ever getting multiple myeloma in the first place.”
That’s why company researchers are investigating whether certain genetic markers can signal which patients with smoldering myeloma are at the highest risk of progressing to multiple myeloma. They are also studying whether certain treatments may benefit patients with the precancerous condition.
About 15% of patients with multiple myeloma will also be diagnosed with AL amyloidosis, a rare disease that occurs when a protein called amyloid builds up in organs like the heart, kidneys, liver and spleen. Like multiple myeloma, AL amyloidosis affects the plasma cells inside the bone marrow and may cause permanent organ damage if not treated early.
Early diagnosis can prevent organ damage down the line, but because symptoms of AL amyloidosis—like shortness of breath, fatigue and swelling in the legs—mimic other conditions, it can be hard to diagnose. Through a strategic partnership with Ultromics, Johnson & Johnson is working on an artificial intelligence algorithm that can analyze echocardiograms in patients with multiple myeloma or smoldering myeloma and detect subtleties that may indicate if the patient has amyloidosis.
The patients who do show evidence of amyloidosis then go on to get a heart biopsy to confirm the diagnosis. “This way, if you have 100 patients, the algorithm may help identify two who possibly have amyloidosis and need a biopsy, versus doing a biopsy of all 100 patients,” says Dr. Schecter.
While therapies exist to treat many cancers, one challenge can be physically accessing hard-to-reach areas where malignant tumors may grow.
For example, bladder cancer, which affects 800,000 people in the United States, rises from the bladder lining, which makes it challenging to physically access treatments. “Liquid drugs don’t stay in the bladder for long, since they are excreted in the urine,” explains Chris Cutie, M.D., Vice President, Disease Area Leader, Bladder Cancer, Johnson & Johnson.
“As a urologist, I knew we needed to develop an effective way to release a drug within the bladder at a low continuous dose that would limit systemic side effects,” explains Dr. Cutie. So, his team initiated the study of a new treatment approach for bladder cancer: an investigational novel targeted releasing system that’s inserted into the bladder and steadily delivers therapy directly through this proprietary device technology.
“This device relies on osmosis,” explains Dr. Cutie. “When we place it into the bladder, over several weeks, treatment diffuses out locally into the lining of the bladder.” The device recently received Breakthrough Therapy Designation from the Food and Drug Administration (FDA).
Scientists are also looking into whether the combination drug-device can be combined with other treatments.
Reaching tumors in the lung, for example, with traditional diagnostic methods can also be tricky. Not having full physical access to these areas means these cancers are more likely to be diagnosed at a later stage.
That’s why having innovative tools is key to catching certain cancers early. Johnson & Johnson MedTech’s Monarch™ Platform for Bronchoscopy, for example, allows physicians to examine hard-to-reach areas of the lung where conventional bronchoscopes have greater challenges with access and stability. Physicians utilize an instinctive handheld controller and two robotic arms to drive a thin, flexible scope into the patient’s airways. The technology utilizes real-time, adaptive navigation and constant visualization, even in the periphery of the lung where about 70% of nodules are located.
This reach and access to the periphery could potentially extend beyond diagnostic procedures to find lung cancer at an earlier stage. Researchers are now studying how minimally invasive procedures can potentially aid in lung cancer treatment.
“We are working on a number of clinical trials to examine whether we can deliver novel therapies directly into the tumors that kill cancer cells or activate the immune system to kill cancer cells,” explains Philippe Szapary, M.D., MSCE, Clinical Development & Scientific Affairs Head, Interventional Oncology (INTO) at Johnson & Johnson.
INTO, a convergent R&D team, is integrating Johnson & Johnson’s Innovative Medicine and MedTech expertise to develop intratumoral therapies to help improve patient outcomes in lung and adjacent cancers. “The hope is eventually we will be able to use the Monarch Platform to locate and access tumors and deliver therapeutic modalities directly into the lesions using purpose-built drug-delivery systems to optimize the effect of each modality,” explains Hannah McEwen, Ph.D., Head of Engineering Sciences, INTO at Johnson & Johnson.
Additionally, through a licensing agreement with biotech company Nanobiotix, the INTO team is exploring how Nanobiotix’s investigational radioenhancer, NBTXR3, may help make radiation therapy more effective in head, neck and lung cancers.
Another approach Johnson & Johnson is taking to innovate new cancer therapeutics: identifying which patients would respond most positively to a particular treatment, so that time isn’t lost giving treatment to someone who won’t benefit.
One example: Johnson & Johnson has an approved medicine for helping treat metastatic urothelial cancer, and it is effective in patients whose tumor has a specific abnormal gene.
The drug was approved for use in conjunction with a companion diagnostic, which is administered by healthcare providers to identify the patients who may benefit most from the bladder cancer treatment—a precision medicine-based approach to getting the most effective treatment to a patient who has certain genetic alterations.
Another medicine became the first targeted therapy approved by the FDA for advanced nonsmall cell lung cancer in patients with a specific genetic mutation. A Johnson & Johnson therapeutic was also FDA-approved for use as a first-line targeted treatment for patients with prostate cancer who carry a certain mutation and for whom chemotherapy is not clinically indicated.
Currently, Dr. Schecter is focusing his efforts on another precision medicine innovation: cell-based therapies for the treatment of blood cancers. This approach involves genetically engineering a patient’s own immune cells to target and kill cancer cells. Currently, such treatments are only available to patients who have unsuccessfully gone through multiple lines of prior therapy, but the hope is to bring the treatment into earlier lines of therapy—potentially paving the way for improved outcomes in the future.
As is the case with many diseases, cancer doesn’t impact everyone in the same way. For example, in the U.S., Black people experience the highest cancer death rates and the shortest survival times of any population group. And compared with white people, Hispanic men and women are less likely to be diagnosed with lung, colorectal, breast and prostate cancers—the most common types.
One way to begin reducing these disparities is by increasing representation in clinical trials. Barriers such as limited outreach have prevented historically marginalized communities from participating in clinical studies. And inclusiveness is crucial, so researchers can determine which medicines and therapies will work for all people with cancer.
Just a few examples of how Johnson & Johnson has shown its commitment to diversifying clinical trials: Last year, the company donated $3 million to the American Cancer Society’s Navigating Patients Across the Care and Treatment Continuum program, an initiative that’s increasing awareness and access to clinical trials among racially and ethnically diverse communities. “The grant will be awarded to about 20 different cancer health systems throughout the U.S. to support innovative and impactful strategies to overcome access to barriers,” says Mark Wildgust, Ph.D., VP of Oncology, Global Medical Affairs at Johnson & Johnson. This may include nurse navigator support throughout the clinical trial process, from addressing comprehension and literacy gaps to ensuring compliance with protocol-specified evaluations.
In addition, the company also provided a $5 million sponsorship to Stand Up to Cancer to increase diversity in early-phase cancer clinical trials. Globally, Johnson & Johnson’s support of the African Access Initiative is helping improve access to cancer care and representation in cancer clinical trials in countries throughout Africa.
Currently, Johnson & Johnson is recruiting participants for the LIBERTAS study, a clinical study of patients with metastatic prostate cancer. It is the first oncology program at the company that’s intentionally transgender-inclusive.
Conducting a transgender-inclusive trial is important, as survival rates among transgender people with prostate cancer are shown to be worse than those of cisgender men with the disease. “The hope is that research from the LIBERTAS study will help improve detection and treatment strategies in both transgender and nonbinary people,” explains Wildgust.
Because that’s the purpose of Johnson & Johnson’s work in oncology: helping change the lives of all people who live with cancer, while working tirelessly to end the disease once and for all.
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