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Head of Personalized Medicine at Roche
(Photo: Roche)
Mr. Lattrich, how much coincidence is there in our medicine?
In our healthcare system, a lot depends on chance, even if you might not notice it that much. You feel ill, you go to the doctor - and this is where coincidence comes into play. Which doctor do you go to? Is he up to date on the treatment of your condition? Does he have the necessary equipment to treat you properly?
And where does this doctor refer you if further treatment is necessary? Come to a facility that has the latest technology and know-how, or to a clinic that may not have all the options for targeted therapy. I'm also thinking here, for example, of surgical therapy, where a patient can hardly assess the quality of the treatment in advance.
But coincidence also plays a major role in drug treatment: is the treatment based on the latest medical findings? Are newly developed drugs already being used? Finally, the aftercare: At what intervals does it take place? Is the patient being adequately cared for? Are they perhaps even oversupplied, according to the motto: a lot helps a lot - which can then become a new burden.
The quality of medical treatment, as these examples make clear, depends on many factors that are also influenced by chance.
What would it take to eliminate this coincidence?
You will never completely eliminate chance. But today, in the age of digitization, we have the opportunity to share medical knowledge widely. I'm thinking of data from medical and pharmacological studies, but also data on the course of diseases that is generated daily in clinics and general practitioners' practices. This is a vast body of medical knowledge that would be invaluable to us in patient care, because this data represents decisions - good and bad, successful and less successful - we could learn from for each subsequent decision and for each subsequent patient.
But far too often this information is not used - it is not recorded in a structured way, is often only available on paper or is only stored on site and is therefore only available to a small group of people. So we haven't learned much from it so far. Why don't we network more closely here? We have the technical possibilities for this.
I'll put the question back to you right away: why not?
In general, we find it difficult to exchange data in this country, especially when it comes to personal data such as health data. We encounter many reservations, some of which do not even want to be overcome. That doesn't make it easy to find a solution. In addition, the individual benefit for those who are supposed to give their consent to the use of their medical data is not always immediately recognizable.
I think education and building trust play a central role here: data exchange in medicine is not about spying on individuals, but about interpreting large amounts of anonymous data in order to identify patterns in the course of diseases and treatment successes.
What is the significance of institutionalized data protection here?
Data protection is good and important, but we should strive for a European regulation that is as uniform as possible. We have the European General Data Protection Regulation and I see no problem in using medical data in compliance with this regulation. The only important thing is that everyone who has a legitimate interest in using it - be it scientific institutions, clinics or pharmacological research - also has the same access.
From my point of view, legitimate interest means: interest in research that can significantly improve the care of patients, for example in oncology. Here I have the impression that data protection is used as a pretext to keep doors closed and that research-based pharmaceutical companies in particular are distrusted. This is problematic because that is where therapeutic innovations are developed and produced. However, companies like Roche have been conducting clinical studies with thousands of patients for decades, and we have always carefully and successfully protected their data.
One way would be, for example, to pool the data collected from different sources in a central facility. Upon request, this facility could then provide the questioner from the pool with targeted data on specific issues.
Would such data be the fuel for personalized medicine?
I would rather speak of the impeller or catalyst here, because fuel burns and is then gone. Ideally, however, medical data sets will become more and more extensive and thus enable us to gain ever more precise knowledge. For example in cancer research: Here we already have the opportunity to create comprehensive molecular-genetic tumor profiles - sometimes from a few milliliters of blood. Hundreds of genes are examined to find out what drives the cancer and to develop individual therapies tailored to this.
This data is extremely interesting for both healthcare and research, especially when combined with other data, such as what treatments patients received and how they went. In fact, that is not happening today - for the well-known reasons. We are wasting a huge opportunity with this.
How important is personalized medicine for Roche?
We want to set new therapeutic standards that can make a real difference in the life and quality of life of patients - and these are not drugs that are used by everyone according to the watering can principle, but personalized treatment strategies that are tailored to individual needs as best as possible adjusted by patients.
Let's stay with the example of cancer: We now know that cancer has very individual characteristics in each person affected - accordingly, individual treatment strategies are also required. And that's no longer fiction: the one-size-fits-all approach has been increasingly being replaced in oncology for a number of years by personalized drugs that prevent disease mechanisms with great precision.
At Roche, we introduced the first targeted treatment for women with a specific form of breast cancer more than 20 years ago, thereby significantly increasing the chances of recovery - today we also offer corresponding treatments for other types of cancer, such as specific forms of lung or skin cancer. Personalized therapy options have already turned a few months of survival into many years.
These examples show us what is possible if we understand the molecular causes of cancer and attack them in a targeted manner. So far, not all patients have benefited from it. The challenges we face are still great. It is important that we team up with competent partners. In view of the complex problems of modern medicine, such cooperation is the key to making our healthcare system better.
What role will chance play in medicine in, say, five years?
Coincidence is part of our life, it will continue to be part of medicine. My hope is that we will come to a constructive cooperation in the future, in which data protection will no longer be misused as a hurdle and that we will be able to make all the information that doctors and pharmacologists have collected usable for the general benefit of the people.
In the future, patients should no longer have to worry about which doctor or clinic they go to. Ideally, the data necessary to make an informed, individual, best possible therapy decision is available everywhere. In order to get there in five years, however, we have to keep up.
