“One of my mentors instilled the importance of perfecting a pitch, and I took it to heart. So, when someone asks me what I do at Foundation Medicine, I tell them: 'My team uses genomics and outcomes data from the last decade to optimize cancer treatment for patients in the next decade.’”
Ryon Graf is a Director of Clinical Development and Head of Real-World Outcomes Research. His team makes use of the Foundation Medicine – Flatiron Health Clinico-Genomic Database (CGDB) with clinical, pathological, outcomes, and genomics data from over one hundred thousand patients. His team’s primary role is to generate insights from these data that can be useful for patient care. Doing so requires a unique intersection of skills, including data science, biostatistics, genomics, and clinical acumen, among other things.
“It’s impossible to be an expert in all of these areas, so my team are generalists” he explained. “It requires a certain amount of humility and courage to constantly understand one’s limits, and to reach out and seek someone else’s expertise, because someone is always going to be a little bit better in one of those key areas. It’s full of healthy challenges and very rewarding.”
Ryon is a veteran of the San Diego biotech startup realm. Prior to Foundation Medicine, he was part of the team that developed a liquid biopsy diagnostic product that is used to improve a critical decision in the care of men with metastatic prostate cancer. “I was part of a wonderful jazz band of senior scientists of various disciplines and backgrounds. We proudly took a product concept all the way to Medicare reimbursement in less than 5 years.”
Before the hop into biotech, Ryon defended his PhD in Biomedical Sciences at Sanford Burnham Prebys Medical Discovery Institute, doing most of his dissertation research at the nearby University of California San Diego (UCSD) Moores Cancer Center. While he was mostly a laboratory scientist during the course of his research, he was able to glean exposure to the clinic at the UCSD School of Medicine through a program called Med-into-Grad.
“I studied clinical oncology and a bit of pathology, and while I am in no way sufficiently qualified for these tasks, my time in the clinic helped me to understand how impacts can be made in treatment decisions and what information is useful for physicians. It inspired me to pursue a career where I could generate practical insights to improve patient care. I became obsessed with evidence, and generating sufficient information of value for real-world use,” Ryon explained.
That in part led him to his current role, where he and his team turn real-world data into real-world evidence: insights that are valuable enough to be used to inform clinical practice. He and his team examine gaps in knowledge, the decision-making process in the clinic, and collaborate with healthcare providers to distill that information into key decision points that might be improved making use of the CGDB. Ryon’s approach is largely informed by the time he spent working within prostate cancer research and diagnostics in the startup realm.
This often leads to insights that are shared via abstracts at medical conferences with the oncology community. Ryon’s team, along with clinical collaborators at academic medical centers, recently won Best Genitourinary (GU) Poster at the European Society for Medical Oncology (ESMO) meeting in Paris in September of 2022. The team examined the treatment of de-novo metastatic castration sensitive prostate cancer (mCSPC), hypothesizing that the presence of mutations in one specific gene, found about 10% of the time in men with prostate cancer, would lead to greater effectiveness of newer hormonal agents. Using CGDB, they observed that this was indeed the case, while men treated with standard chemotherapy did not have that extreme benefit. The study was simultaneously published in Clinical Cancer Research. The results are clinically valuable, because there were previously no molecular diagnostics to aid this critical treatment decision.
Other work by the team includes helping determine when immunotherapy may be a better option than chemotherapy, when there might be sufficient signal for liquid biopsy (tumor profiling from a blood draw), when archival biopsies (biopsies collected before cancer advances to other parts of the body, usually with primary tissue) can be valid, and more. Moving forward, Ryon sees a future where insights from databases such as CGDB can support a wide array of useful insights for patient care.
“Gold standard randomized controlled trials do not exist for many critical treatment decisions. This is where real-world evidence can really help.”
With November marking Men’s Health Awareness Month, Ryon puts his team’s research in context: “Most of the research we do is valuable to men who already have an advanced prostate cancer diagnosis,” Ryon explained. “But the amount of progress in the last 10 years has been utterly astonishing in terms of new drugs and diagnostics. Deaths due to prostate cancer have dropped by half since 1990, and that is due to many small things that add up – better screening, better surgical techniques, better radiation, better drugs, and better diagnostics – all little pieces of progress from efforts of thousands of researchers.”
For the team, advancing men’s health means real-world evidence that allows for improved treatment of prostate cancer: to extend life and quality of life. This includes the work they are doing that spans from their cutting-edge research presented at ESMO, to their work in determining good signal for liquid biopsy and appropriate times to use archival biopsies. Each small piece adds to progress in the field.
Ryon emphasizes what he’s learned from patients: “At Foundation Medicine, we seek to add years to lives of cancer patients. One of the things I’ve learned from patients is the importance of also adding life to years. Time is everything to a patient with metastatic cancer. I’ve learned how incredibly valuable they see their time here, and to give a cancer patient more time is to give somebody time well lived. We all have the capability of living that way, even if we don’t have cancer.”
As Ryon and team continue to drive forward this research to improve patient care, they carry that mentality with him, adding life to their years through their connection to Foundation Medicine’s mission and the work they do each day.
Ryon recently moderated a LinkedIn Live event titled "How Two Prostate Cancer Patients’ Search for Answers Led Them to Genomics” with the Bryce and Brian (pictured above with Ryon). View the recording of the video here.