Thought Leaders in Liquid Biopsy: A Conversation with Dr. Phil Febbo (CMO, Illumina)
Phil Febbo, MD is the Chief Medical Officer at Illumina. Prior to joining the company, Dr. Febbo ran a translational laboratory focused on using genomics to understand prostate cancer at the University of California-San Francisco and practiced as a genitourinary oncologist.
Throughout his career, Dr. Febbo has served as a primary investigator for the Translational Research Program of The Alliance for Clinical Trials in Oncology, where his work focused on incorporating biomarkers into large clinical trials. At Illumina, Dr. Febbo is responsible for developing and executing the company’s medical strategy to drive genomic testing into healthcare practice.
We spoke with Dr. Febbo to learn more about barriers to access associated with liquid biopsy technology and the role that BLOODPAC can play in mitigating those challenges.
As a clinician, what have you seen as the biggest challenges patients and clinicians face in navigating detection, diagnosis and treatment of cancer?
The challenge really starts with detection. There are multiple factors that affect the efficacy of cancer screening in the general population. For the handful of cancers that have screening tests—namely, breast, colon, prostate, lung, and cervical cancers—the exams require relatively lengthy, invasive procedures. Think about the hassle that going in for a mammogram, chest CT scan, Pap smear, or colonoscopy entails. Secondly, and more importantly, we have many hundreds of types of cancer where there’s no early detection. I believe that over the next decade blood-based tests will come into routine use, both in screening for cancer as well as in treatment decisions and monitoring. So, between empowering individuals to have the agency to detect cancer earlier and giving clinicians and patients tools to understand their disease at a genetic level, that’s where liquid biopsies will really transform cancer care.
How do liquid biopsy tests work?
When we talk about liquid biopsy, we’re generally talking about a blood sample. Your blood contains a huge amount of information—it has blood cells, immune cells, and all the other building blocks of life including proteins, DNA, and RNA shed from your healthy cells. If you have a tumor somewhere in your body, your blood will also start to contain parts of that those cancerous cells. The field worked very hard for 20 years to develop tests sensitive enough to detect that cancer signal, because the vast majority of what’s in the blood is non-cancerous material. What you’re collecting in that blood sample is maybe just a few cancer cells, with a very small amount of total DNA. But now you don’t have perform a CT scan or put a needle through the skin to get a biopsy: you can draw the blood and use emerging technologies to read the cancer signal.
How can liquid biopsies help overcome barriers to cancer care and patient access?
The single biggest advantage of a liquid biopsy with respect to patient access is that it’s so much easier to administer than traditional procedures. I already mentioned some of the barriers to cancer screening and treatment that individuals experiences, including taking time off to go to a medical center, perhaps finding childcare and transportation as well. We’ve also seen that people are more comfortable with a blood draw, which can happen within a community. As we’ve seen during the pandemic, companies have become very good at sending phlebotomists into the local drugstore, community center, health clinic, or even into the home. So, I do think the integration of blood-based biopsies into cancer early detection will have a major impact on the adoption such preventative measures on a population-wide scale.
What is BLOODPAC doing to ensure that liquid biopsy technology is implemented in an equitable manner?
What we all recognized early on in BLOODPAC is that liquid biopsy technology has the potential to address disparities and bring the best cancer care out of the hospitals and clinics and into the homes of individuals. However, we also have to realize without specific attention, liquid biopsies and their benefits will only be realized by a small part of the population. So we’ve committed our next five years to addressing the key barriers that limit accessibility. The first step towards that goal was pulling together stakeholders from patient advocacy, the government, commercial entities, and academic centers to publish a study on the barriers to accessing liquid biopsy, which we’re hoping to get out in a few months. As part of this initiative, we’re challenging ourselves to ask what BLOODPAC can do so that in five years, as liquid biopsies really become part of the fabric of care for a cancer patient, those biopsies are available to all.
What would you say to organizations that are considering joining BLOODPAC?
You know the saying, “You can go fast alone, but you can go far together”? My experience over the past five years with BLOODPAC has been such pride at how far we’ve come together. The reason I prioritize being part of the organization, despite my obligations at Illumina and with my family at home, is that this opportunity is too important to miss. BLOODPAC is not exclusive: any entity that sees their mission aligned with our mission, which is to provide high-quality liquid biopsies to cancer patients, is open to join. Our membership is growing every year, and I think more and more academic groups, industry groups, and members of different federal agencies will see the value of participation and make the same prioritization. There’s always more room here because there’s a lot of work to do!
