A well-known health policy expert whose work has focused on the cost and value of cancer drugs has left academia and accepted a position with a biotechnology company.
Peter Bach, MD, was the director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center (MSKCC), New York. He is now the chief medical officer of Delfi Diagnostics in Baltimore, Maryland.
Delfi is developing a new class of liquid biopsy for the early detection of cancer. The technology is based on modified genome-wide fragmentation profiles, also known as “fragmentomes”. Through the application of advanced machine learning algorithms, the test has already demonstrated proof of concept by accurately detecting cancer from these cell-free DNA fragments and determining where in the body the tumor has grown. developed.
“We are extremely happy that a luminary like Peter is joining the Delfi team,” commented Victor Velculescu, MD, PhD, founder and CEO of Delfi. “Peter’s expertise in lung cancer will be critical in the short term as we complete our lung cancer studies and plan to commercialize a lung cancer screening test, and his in-depth knowledge of the economics of lung cancer. health and other applications will help ensure that Delfi can meet its goal of providing affordable and accessible testing to all who need it, ”he said. Medscape Medical News.
Bach is well known for his research on drug pricing and has developed new drug pricing models that include value for patients. He made headlines in 2012 when, along with other doctors at MSKCC, they drew attention to the high price of a newly approved cancer drug, aflibercept (Zaltrap). In one New York Times opinion piece, they said it was “no better” than bevacizumab (Avastin), which cost less than half of what aflibercept cost. The MSKCC announced that it would not use aflibercept, and the price of the drug was later halved by the manufacturer.
Not really a switch
Bach says his new job isn’t really as big of a change as it might seem at first glance. He pointed out in an interview that although much of his recent work has focused on the pricing of pharmaceuticals, he has spent nearly 15 years of his career working on the early detection of cancer, “primarily in the field of cancer. lung cancer and in particular early risk prediction models, ”he said. .
He has been involved and interested in lung cancer screening since the early days of its inception. He was involved in testing or preparing guidelines, and he initiated a Medicare application that resulted in nationwide coverage of lung cancer screening.
Bach said his voice will always be heard on social media regarding drug prices, but he also said the situation has changed. “There is now a huge group of very good researchers working on these issues, and it’s different from 10 years ago when I started,” he said.
“The real goal of drug pricing has always been access and reimbursable costs,” Bach said. Medscape Medical News. “Delfi has what appears to be transformative technology, both on the sensing side and on the cost platform side. This means possible access for people with limited access and people who have been left behind with LDCT [low-dose CT] lung cancer screening. “
Only about 16% of people who meet LDCT eligibility criteria receive it. This despite the fact that “lung cancer has some of the strongest evidence we have in cancer screening, up there with Cervical cancer and colorectal cancer screening, ”he said.
“There is some really solid data, but this low average masks the fact that people in poorer or poor states have much lower rates that are only a fraction of the national average,” he said. he declares.
Bach says the liquid biopsy test to detect early cancer that is under development at Delfi has already obtained proof of concept. “The data suggests this could be the first foray into vastly improved access and therefore reduced mortality,” he said. “So it all fits together.”
From an economic standpoint, early detection of cancer makes sense. “Quite simply, early cancers are less expensive to treat,” Bach said. “And of course the patients are much better off. It should be noted that if we can detect cancer earlier, we can save costs, given the cost of treatment.”
New class of liquid biopsy
Delfi notes that unlike technologies that simply look for changes in DNA sequences, methylation or proteins, its technology allows for high sensitivity and high specificity tests that are unaffected by confounding conditions such as hematopoiesis. clonal of undetermined potential, aging or other diseases.
The company first announced results with its technology in a study published in 2019 in Nature. In this study, which involved over 400 patients, sensitivity ranged from 57% to over 99% among seven types of cancer, and specificity was 98%.
In a study presented at this year’s annual meeting of the American Society of Clinical Oncology (abstract 3058), the researchers used Delfi’s approach to measure the fragmentation of cfDNA in the plasma of the 412 patients included in the study, using a cross-validated machine learning model. Cancer patients were distinguished from those without cancer with high sensitivity and specificity (AUC = 0.92). These included patients with common cancers, such as colorectal cancer and lung cancer.
Delfi was founded in 2019 with $ 5.5 million in seed funding led by Menlo Ventures. As of January 2021, the company had raised $ 100 million in funding. He plans to use this to expand his team of cancer researchers and machine learning experts and to validate his new next-generation liquid biopsy technology through several prospective clinical studies.