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Fabrice André: Personalised cancer treatment

Researcher portraits Article published on 09 June 2020 , Updated on 17 September 2020

Fabrice André is a doctor of medical oncology, professor at Université Paris-Saclay and researcher at the Institut Gustave Roussy, where he leads the team of around a hundred researchers at the Molecular predictors and new targets in oncology mixed research unit (PMNCO - Université Paris-Saclay, Institut Gustave Roussy, Inserm).

All these researchers share the same goal: find medication to treat each cancer. This is done through large-scale molecular analyses of patient cohorts to identify cancer anomalies, using bioinformatics, and to then match them with the right combination therapy. The ultimate goal is to create a virtual tumour for each patient and to then provide them with personalised treatment.

Every year, 16 million people suffer from cancer in the world, and 9 million of them die. “Even if you find a medication for just 1% of those people, that will save 90,000 people per year, or almost a million over 10 years.” This is more than enough to motivate Fabrice André and his team. “The goal of our research is to find new biomarkers, to select patients who are elligible for therapeutic trials. We analyse the samples using new high-throughput molecular analysis technology (genome, single-cell, protein analyses). This technology helps us to identify, among the tens of thousands of pieces of cross-sectional data, the anomalies in the molecular landscape of cancers or in the combinations of genes that predict relapse or resistance to treatment,” he explains. As a result, the researchers identify the drivers that trigger cancer progression.

An ongoing research cycle

Once these genes have been identified, they are targeted with medication tested in clinical trials. To find new targets, the researchers compile cohorts of several hundreds of patients, for each type of cancer. “It’s an ongoing task, and as soon as a new situation comes to light in oncology, we embark upon an ‘industrial process’. We aim to identify new potential candidate targets based on response to treatment, using sequencers and molecular analyses on the whole genome,” explains Fabrice André. “Since the research unit was created 9 years ago, we have reached a stage of maturity where we are producing molecular tests that can predict which treatment suits each patient”.

Personalised treatments

Molecular modelling on an individual scale is a part of a joint project with CentraleSupélec. “The goal is to be able to create a virtual tumour for each patient within 5 years.” Fabrice André uses this scientific approach in particular, to study metastatic breast cancer. This particular type of cancer causes between 500 and 600,000 deaths per year in the world for 1.5 million new cases, including 12,000 deaths in France for 60,000 new cases. “With large-scale profiling, we aim to identify the differences between these cancers and those that do not develop metastases. As soon as we find the cause of its progression or resistance to treatments, we can move on to clinical trials,” explains the researcher, who is currently testing a medication that could lead to immunity against a certain sub-type of breast cancer, for which he has just discovered the alteration in the genome.

Change patients’ lives

Fabrice André wrote two major articles in 2019, one appeared in Nature, and the other in New England journal of medicine. He is one of the most highly cited researchers (HiCiSci) of Université Paris-Saclay. But rather than focus on the number of articles he has published, he prefers to focus on the goal of his research “to generate a product that will change the lives of patients”. The oncologist, currently the research director at the Institut Gustave Roussy, professes: “Cancer is now the second highest cause of death in France, behind cardiovascular diseases, making it a real issue in today’s society. The role of Gustave Roussy, one of the top cancer research centres in the world, is to create products that can have a measurable societal impact”.

An ongoing challenge

Fabrice André was a young professional skier from Villard-de-Lans, when he decided to start studying medicine in 1991, to be better prepared for the STAPS (Science and techniques for physical and sports activities) competitive exam. This was when he discovered his passion for medicine. He later chose to specialise in oncology, because “that’s where the biggest challenges of that time were”, and from the offset, he set himself the goal to combine his clinical work with research. In 1996, he began his first semester as an intern at Gustave Roussy, almost by accident: “Sometimes we have to seize opportunities when they present themselves. Life is not as simple as following A to Z”. However, his career really took off in Houston, when he completed his post-doc in 2006. “We were experiencing the very beginning of high-throughput research which allowed us to identify the abnormal gene in tumours. Along with my mentor, we decided to try and use this technique for modelling cancer, a very advanced concept at the time,” remembers Fabrice André.

Saclay, a pool of expertise

“Our research covers a wide range of fields, from very basic research to applied research. Université Paris-Saclay is full of talent across a diverse scope of basic research disciplines. Cancer research is in great need of this talent. Each field needs to get involved in the fight against cancer,” observes Fabrice André. To attract such talent, interdisciplinary training programmes are used inside the laboratories themselves. “We train PhD and post-doc students for 18 months to 2 years. Whatever their discipline - mathematics, bioinformatics, physics, chemistry, psychology - , my role is to convert their expertise into something that can be used for the benefit of the patients.”

Fabrice André is the winner of the "Young Investigator and Career Development" award from the American Society of Clinical Oncology (ASCO). He has written more than 350 articles for scientific journals. He is the editor-in-chief for Annals of Oncology and is a member of several scientific bodies and learned and academic institutions (ASCO, ESMO, AACR).