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Julian Upton is Pharmaceutical Executive's Online and European Editor. He can be reached at firstname.lastname@example.org
Pharm Exec talks to Rob Johnson, managing partner and co-founder of Alacrita, about pharma’s relationship with medical imaging.
Pharm Exec talks to Rob Johnson, managing partner and co-founder of Alacrita, a pharmaceutical consulting firm that consults across various aspects of due diligence, including science and technology, about pharma’s relationship with medical imaging.
Rob Johnson: The landscape for medical imaging is continuously changing, as new software is being updated and new hardware is brought to market.
To give some background, in oncology, we’ve started to see more and more Positron Emission Tomography (PET), a nuclear medicine functional imaging technique that is used to observe metabolic processes in the body as an aid to diagnosis disease.
Move across to osteoarthritis (OA), and the techniques for a magnetic resonance imaging (MRI) have improved over the years to form pictures of the anatomy and the physiological processes of the body in both health and disease, but the cost of MRI scans has meant X-Ray imaging is still the most common choice in imaging OA patients.
Then, there is optical coherence tomography (OCT) which uses coherent light to capture micrometer-resolution, two- and three-dimensional images from within optical scattering media (e.g., biological tissue). OCT is based on low-coherence interferometry, typically employing near-infrared light. The use of relatively long wavelength light allows it to penetrate into the scattering medium. OCT is a prime example of an imaging agent development that has the ability to evaluate ophthalmology pharma conditions.
In terms of medical imaging and pharma, it’s a two-way relationship. Healthcare providers, such as the NHS need medical imaging to diagnose patients, who are then given a course of treatment which is developed by pharmaceutical companies. This relationship is key, and is why collaboration and an understanding of both sides is so important, so we can make new developments.
In general, the pharma industry does not invest in medical imaging because it’s not its strength. The industry is very clear in its focus of investing in pharmaceutical development. Likewise, the medical imaging industry does not go into the pharma world. There are a few hybrid companies that work in the area of diagnostics such as Bracco and Curium. In some respects, they are beginning to bridge the gap between pharma and industry, but their return on investment is significantly less in the pharma industry. It’s a new challenge for both industries, that’s why only a few companies are exploring this.
One of the biggest challenges is pharma trusting the imaging core labs. Core labs process data, and the quality on some occasions can fall below what’s expected. If the quality is lacking, the noise around that can make the loss of the end point very easy. Then, people ask should we not just use the site or the Principal Investigators to manage the end point? My answer would be no, because you’ve got no control over local radiologists and no audit or anything else mapped into that, which would cause far greater problems.
One of the biggest challenges for pharma is that, most pharma staff have no knowledge about imaging, or how to manage imaging in a clinical trial. Therefore, they don’t know the right questions to ask, and don’t understand the current challenges and issues. The other thing I have found, is that most core labs don’t understand the pharma industry because most people have never been in big pharma. It’s a process of understanding where the holes are, and where the gap needs closing, and there’s no one really bridging that divide. That’s where Alacrita can come in to offer help and assistance.
Slightly. It’s not making as much impact as people would expect at this stage, because you’ve still got a radiologist looking at the images -a human being. If you consider the human piece, AI is still not there.
A new diagnostic only becomes useful if there’s a therapeutic or change in the way you treat someone. Imaging is only useful if you’re going to alter, or potentially alter, the outcome of the patient, so if there isn’t a particular therapeutic area covered, then why develop the diagnostic? Of course, the pharma industry wants the diagnostics because that’s how it gets its therapy into use. It’s always a catch-22. Both sides need each other to work in harmony, to progress new areas, or to develop new outcomes, and fortunately we have academics that do that very well.
Rob Johnson is managing partner of Alacrita.