Biomarker Testing Gaps Can Stall Targeted Oncology Therapy, BMS’s Dr Pennell Says

In the second segment of an interview with BioPharm International®, Nathan Pennell, MD, PhD, FASCO, senior vice president, head of Hematology and Oncology Medical Affairs, Bristol Myers Squibb (BMS), discusses biomarker testing barriers in targeted oncology, clinical trial diversity, and shared decision making in multiple myeloma.

Dr Pennell notes that the oncology field has moved toward targeted treatments guided by biomarkers that identify the patients most likely to benefit. The process can break down at several points, however. Tissue must be collected in sufficient amounts and processed correctly, the right test must be ordered, and results must reach clinicians who can interpret them, he explains.

"It's tremendously exciting, but it only works if you can actually identify the right patient," Dr Pennell emphasizes.

Addressing these barriers requires the entire cancer community, he stresses. For example, BMS works with practitioners, patient advocacy organizations, health systems, and pathology organizations to help ensure that pathologists are comfortable with assays, that interventionalists can collect tissue, and so clinicians can order and interpret tests. The company also provides educational materials and tests whether efforts work in practice. Dr Pennell explains that development and biomarker strategies must be discussed together early so the community is ready at approval.

Why does clinical trial diversity matter for targeted oncology drugs?

Trials must represent the patients who will receive treatment, Dr Pennell states. This approach means locating trials in the communities where patients receive care and ensuring investigators reflect those populations. BMS has exceeded its goal in this area, with more than 60% of its US clinical trial sites located in diverse communities, which the company defines as comprising at least 30% non-white population, Dr Pennell says.

In multiple myeloma, Dr Pennell notes that expanding options complicates treatment selection. No single treatment suits every patient, he points out, and progression-free survival alone does not decide the choice. Comorbidities, treatment goals, side effects, preferences, and distance to a tertiary care center matter, he stresses. In his role, Dr Pennell says that medical affairs provides unbiased, non-promotional education so physicians and patients can decide together.

Explore more insight in the first segment of Dr Pennell’s interview.

About the speaker

Nathan Pennell, MD, PhD, FASCO, Senior Vice President, Head of Hematology and Oncology Medical Affairs, Bristol Myers Squibb

In his role at Bristol Myers Squibb, Dr Pennell leads medical strategy and works to translate pipeline innovation into progress for people living with cancer. He previously spent nearly 2 decades at Cleveland Clinic, directing its Lung Cancer Medical Oncology Program, serving as its vice chair of clinical research, and authoring more than 100 peer-reviewed publications in journals such as the New England Journal of Medicine, Nature, and The Lancet. Dr Pennell is a former American Society of Clinical Oncology (ASCO) board member and former editor in chief of the ASCO Educational Book.