Personalized Medicine for Cancer-Analyzing the Genome of a Tumor

doctor-on-computerDr. Crusher was stunned. She was comparing the Captain’s DNA before his problem had developed with a current sample she had just taken. She discovered that certain genome sequences were missing from the “after” sample.

How did that happen?

More importantly, what could she do to reverse it?

If you are a fan of Star Trek: The Next Generation, you will recognize this story. Genomic profiling is commonplace in the 24th century.  In this episode of the popular TV show, Dr. Crusher uses the transporter to reverse the change to his DNA and return Captain Picard to his original self.  This was science fiction circa 1990.

While we still don’t have transporters in 2011 to let us travel from one location to another or repair DNA, what was science fiction 20 years ago IS becoming today’s reality of personalized medicine for cancer.

President Richard Nixon declared war on cancer in 1971 and, while we have made many strides in that war, we haven’t wiped out this disease because cancer is not one disease–it is many diseases.

Your Cancer Is Unique to You

Traditional medical research identifies a group of patients with the same illness and tests a single biological pathway with one therapy for effectiveness. This works well when the illness is caused by a single strain of bacteria that can be recognized in many individuals with a microscope.

Cancer is unique to each individual. We now know that many cancers are caused by problems occurring in multiple biological pathways, not just one. Researchers are rapidly reaching the limits of traditional research methodologies to study these complexities.

Fortunately, there is a group of forward thinking scientists who have begun to approach this problem from a different direction. I recently had the good fortune to meet Raphael Lehrer, Ph. D. whose company, GeneKey Corporation, is on the leading edge of personalized cancer medicine.

What he told me was eye opening!

Imagine for a moment that someone you know is battling cancer. The primary care physician is working with the oncologist to administer treatment. The oncologist may look for an individual genetic marker for a certain type of cancer to select the right drug.

If the selected treatment works, everyone cheers. But if it doesn’t, the oncologist may need to resort to trial and error to find another treatment that does work. This is particularly true for late-stage cancer patients.

Meanwhile, the patient is on a roller coaster ride of hope followed by despair if the next treatment fails or only partially works. If a working cancer treatment isn’t found right away, the patient may just give up.

A Personal Research Team to Identify the Best Treatment Options

What if the patient had his own research team composed of some of the smartest scientists in molecular therapies?  And they used state-of-the-art technologies to study the genetic information from his cancer? The team would study the entire genome of the tumor and provide the oncologist with an in-depth analysis pointing to the therapies that best match this patient’s situation. They might even find a clinical trial that the patient can join.

The sooner the patient is on the right treatment, the better the outcome is likely to be.  The patient also gains peace of mind knowing that all possible treatments were identified. And, the research team can add these results to a growing base of information that can help others in the future.

This is the leading edge—cancer treatment and research combined. Medicine has become a team effort with doctors and researchers working together. The concept has actually been around for awhile in other areas of medicine.

By late 2006, my father had been seriously anemic for several years. The usual tests came back negative. His doctors were puzzled and wondered if there was a problem with the combination of medications Dad was taking. So the doctor’s asked a consultant pharmacist, an expert in geriatric medication management, to review my father’s situation for something the doctor might have missed.

The consultant pharmacist identified four possible issues. And, yes, one of them proved to be the problem. I was impressed with the meticulous analysis of my father’s symptoms and medications. I had no idea that this type of service was available for patients.

GeneKey Corporation goes into even more depth in the research it performs for each patient.  As Raphael Lehrer Ph.D., the company’s chief scientist, described it to me, they look at the entire genome of a person’s tumor to identify the biological pathways that are sustaining the tumor. Cancer is optimal for this type of research because tumor samples are available. “Often we identify a drug that is typically used for another type of cancer, or a drug not normally used for cancer treatment that could prove helpful for a particular patient.  Oncologists may not think to try these treatments without data like ours pointing to these additional options,” said Lehrer.

Right now, this personalized research is limited to those who can pay for it themselves. Health insurance doesn’t cover it. While costs are coming down, they are still relatively high… about the price of a luxury car.

While only a limited number of late-stage cancer patients can take advantage of GeneKey’s services, I felt it was important to let readers know about this latest development in personalized medicine for cancer.

Do you know someone who needs to know about this?

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