Building the Diagnostic Layer of Modern Cancer Care with Rita Shaknovich and Karina Kulangara of Agilent

For years, precision oncology has largely been discussed through the lens of breakthrough drugs. But there’s another story running underneath modern cancer care: the quiet rise of companion diagnostics. These tests are increasingly deciding who receives those therapies in the first place. In many cases, the real bottleneck is no longer discovering a drug target. It’s building a reliable system for identifying the right patient at the right moment in the disease. That challenge sits at the center of this conversation with Rita Shaknovich, Chief Medical Officer for Life Sciences and Diagnostis, and Karina Kulangara, Associate Vice President of R&D in Companion Diagnostics at Agilent Technologies.Agilent has always had a major role in this field. Rita and Karina explain how companion diagnostics evolved from the original Herceptin test into a vision for a much broader ecosystem spanning pathology, automation, regulation, and global clinical deployment.We dive into Agilent’s recent FDA approval expanding PD-L1 IHC 22C3 PharmDx into ovarian cancer, a development both guests describe as particularly meaningful given the historically poor outcomes associated with the disease. As Rita puts it: “Precision medicine is based fundamentally on scientific truth . . . it brought real results for patients. It brings better survival for patients, fewer side effects from the medication.”Karina offers one of the clearest explanations we’ve heard for why immunohistochemistry or IHC has endured so long in modern oncology. “It’s the ability to detect protein biomarker in the spatial context of the tissue,” she explains, emphasizing that location and cellular context can fundamentally shape how therapies work.What emerges is a picture of precision oncology that is becoming less exotic and more routine. We’re talking not just new drugs, but an entire clinical and technological infrastructure which is designed to match therapies to biology more effectively and over time. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe