What can oncology research teach us about drug development in psychiatry?

‘Our overarching objective is to improve the success and cost-effectiveness of drug development in psychiatry’, says Ntafoulis. ‘An approach we’d like to explore is to identify subgroups of patients in whom drugs with specific mechanisms of action are expected to be more effective.’

In oncology, this approach has already proved to work, using methods such as transcriptome sequencing (analysing all active genes in a cell) to study pathophysiological pathways and find potential drug targets. ‘We could use similar methods to find biomarkers that are predictive of a pharmacological response. However, we will have to overcome several challenges, such as constraints in accessing CNS tissue and phenotypical heterogeneity. In a way, these are reminiscent of the challenges that the field of oncology encountered in the beginning,’ says Ntafoulis.

Ntafoulis trained as a pharmacist in Italy. He obtained his Master of Science in cancer pharmacology in the UK, before coming to the Netherlands with a European Marie Curie grant. As a PhD student at the Erasmus Medical Center in Rotterdam, he developed and implemented preclinical models to investigate the pharmacokinetic/pharmacodynamic (PK/PD) profile of anti-cancer agents against glioblastoma. He will defend his PhD thesis in September 2024.

In his role as a Clinical Scientist at CHDR, he is now busy mastering the principles and practice of clinical drug research and will be trained as clinical pharmacologist. ‘As a senior staff member of the Psychiatry group, I will focus on identifying, developing and validating pharmacological biomarkers for early phase drug trials for mood, anxiety and trauma-related disorders at CHDR. An illustrative example is a CHDR-funded study that aims to explore the effect of ketamine on sleep in patients with depression. This study aims to gain a better understanding of the underlying neurophysiological and molecular mechanisms associated with ketamine’s antidepressant effect, which occurs rapidly but wears off after a while,’ says Ntafoulis.

He finds it inspiring to watch the rapid developments in psychiatry and psychiatric drug development after years of stagnation. ‘I am optimistic that our efforts inspired by oncology will contribute to the development of novel compounds aimed at improving the quality of life for individuals who suffer from mental health conditions.’