There are many terms used in describing personalized medicine including molecular profiling, genomics and precision medicine. As it relates to cancer, all mean that extensive research is done to determine mutations or alterations that can cause a particular cancer type and aid in assessing the most effective targeted treatment options. Such profiling is key to not only choosing the most effective therapy for a specific type of cancer, but also to improve patient outcomes, explained Holli Hutcheson Dilks, Ph.D., Director, Personalized Medicine Operations at Sarah Cannon Research Institute.
President Obama announced in his January State of the Union address that he is launching, a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetes. An increasing emphasis on personalized medicine has already been in the works at Sarah Cannon over the last several years, and Sarah Cannon had led and initiated trials with molecular targeted therapies now approved in lung cancer, melanoma and blood cancers.
"Molecular profiling involves understanding everything possible about a particular cancer through a variety of means, including sequencing the tumor's DNA or RNA to provide the most optimal diagnostic classification possible," explained Dilks. "Once we have the molecular data from a specific tumor, we can determine if there are any available therapies that will be most effective against it."
This is a dramatic difference from the traditional approach that doctors have relied on in the past, and is due to the ongoing research at Sarah Cannon Research Institute and other cancer research facilities around the world. Ongoing collaborations with laboratories that offer innovative technologies, including next generation sequencing (NGS) to identify extensively cancer-related molecular alterations, combined with access to thousands of patients with different tumor types, means that future cancer therapies will be very specifically designed for a particular tumor profile unique to the individual person.
"A great deal of the drug development currently underway is targeting tumors that have specific molecular alterations. So it's a great benefit to the treating physician to know specifically what molecular alteration the patient has in order to choose the right drug. That's what targeted therapy is: a therapy that focuses on treating a specific molecular alteration."
Increasing Cancer Treatment Options
Targeted therapies not only increase the potential for controlling or eliminating the cancer, but can also either circumvent or augment some of the more traditional types of treatment, chemotherapy or radiation, for example and the associated side effects.
A good example, said Dilks, is lung cancer. For example, if a patient with non-small cell lung cancer is identified to have a rearrangement in a gene called ALK , there are two approved targeted drugs known as crizotinib (Xalkori) or ceritinib (Zykadia) used to directly block this abnormal protein to inhibit the growth of cancer cells. Such tailored therapies have demonstrated improved outcomes for those patients who previously would be treated with some combination of surgery, radiation or chemotherapy.
"With molecular profiling and targeted therapy, we are moving to a time when all cancers will be profiled or sequenced, and then people will be given therapies specific to whatever that mutation or alteration is," Dilks noted. "This would not only reduce the risk of patients undergoing unnecessary and expensive treatments, but also offer cancer patients the hope of a longer and better quality of life."
Want to learn more about Sarah Cannon's current personalized medicine initiatives? Read our press release on details discussed at the Personalized Medicine World Conference held in, Mountain View, California. Sarah Cannon's President, Clinical Operations, Howard A. "Skip" Burris, MD, presented on genomic profiling in routine clinical care in tandem with oncology clinical service collaborator, Syapse, the leading provider of precision medicine software. Together with Syapse, Sarah Cannon is launching a precision oncology platform in the second half of 2015, that is designed to support Sarah Cannon's efforts to make tumor genome profiling a key component of the care continuum for the more than 100,000 newly diagnosed cancer patients seen annually across its network of cancer centers throughout the United States and United Kingdom.