Personalized Medicine – an exciting future for cancer research

There was an article published Wednesday in the Toronto Star that we are entering the “Golden Age” of cancer research where we are moving towards new and personalized treatments for cancer patients.

I’m telling you about this because my colleagues at the BC Cancer Agency who are involved in research have been talking a lot about it lately too.

And the BC Cancer Foundation hosted a special donor event a few weeks ago that was all about personalized medicine being the future for cancer research and truly the answer to this disease that we have been working on for so long.

In fact, I’m very excited to be able to share with you the videos of this donor event, so that you can see and hear for yourself how four brilliant oncologists and researchers at the BC Cancer Agency describe personalized medicine.

They are Dr. Janessa Laskin (medical oncologist at the BC Cancer Agency), Dr. David Huntsman (Medical Director of the Centre for Translational & Applied Genomics at the BC Cancer Agency), Dr. Marco Marra (Director of the BC Cancer Agency’s Genome Sciences Centre) and Dr. François Bénard (Scientific Director of the BC Cancer Agency’s Centre of Excellence for Functional Cancer Imaging)

But let me sum it up with the analogy that Dr. Janessa Laskin used that night.  She said if you are buying a new suit and you go to a department store, you might be lucky and find a suit that fits you. But if you go to a tailor, they will ask you the right questions, take the specific measurements and create a suit that fits you perfectly.

And that’s our hope: that one day we will be able to tailor cancer treatment to the individual patient and provide the treatment that’s a perfect fit for that person.

I also happen to know that here in BC we have some of the best “tailors” in the world!

Our researchers all say that the work they are doing and the discoveries they are making are directly linked to the generosity of our donors here in B.C. 

So on behalf of the BC Cancer Foundation, and on behalf of the researchers your donations are funding, I say thank you.

Best Regards,
Nick

7 Responses to “Personalized Medicine – an exciting future for cancer research”

  1. Robyn Sussel Says:

    Hi Nick, do you have any thoughts on how “personalized medicine” may be influenced by clinical trials (or the other way around). My understanding is that clinical trials show us how treatments work in a certain populations. “Personalized medicine” suggests that every individual may have a different treatment option so that “populations” don’t really play a role. Does that make clinical trials obsolete? Or does it mean that clinical trials must change somehow?

  2. Nick Says:

    Great question Robyn.

    Clinical trials will still be a vital part of developing new therapies and I think will become even more important.

    Personalized medicine takes place at the diagnosis stage of cancer; the objective will be to determine the exact type of cancer the individual has, and the right therapy.

    But remember today (in many cases) we aren’t able to differentiate the different types of cance; but as this science moves forward clinical trials will be needed to develop new therapies to treat all of the different types of cancer that we are now able to identify.

    Make sense?

  3. vincentkcng Says:

    The concept would be interesting, instead of mass marketing and adjusting to the majority but to be able to just serve people as actual people…to give them the custom medicine or treatment that is needed would change so many lives. I’m 29 myself, but I know in another 25 years research will be so different. Please keep up the posts, and all the interesting news at BC Cancer!

  4. Gregory D. Pawelski Says:

    Personalized Cancer Medicine Is Here, Now

    As we enter the era of “personalized” medicine, it is time to take a fresh look at how we evaluate treatments for cancer patients. More emphasis is needed matching treatment to the patient. Patients would certainly have a better chance of success had their cancer been chemo-sensitive rather than chemo-resistant, where it is more apparent that chemotherapy improves the survival of patients, and where identifying the most effective chemotherapy would be more likely to improve survival.

    Findings presented at the Annual Meeting of the European Society for Clinical Investigation in Uppsala, Sweden and the Annual Meeting of the American Assoication for Cancer Research (AACR) in San Diego, CA concluded that “functional profiling” with cell-based assays is relevant for the study of both “conventional” and “targeted” anti-neoplastic drug agents (anti-tumor and anti-angiogenic activity) in primary cultures of “fresh” human tumors.

    Cell-based Assays with “cell-death” endpoints can show disease-specific drug activity, are useful clinical and research tools for “conventional” and “targeted” drugs, and provide unique information complementary to that provided by “molecular” tests. There have been more than 25 peer-reviewed publications showing significant correlations between cell-death assay results and patient response and survival.

    Many patients are treated not only with a “targeted” therapy drug like Tarceva, Avastin, or Iressa, but with a combination of chemotherapy drugs. Therefore, existing DNA or RNA sequences or expression of individual proteins often examine only one compenent of a much larger, interactive process. The oncologist might need to administer several chemotherapy drugs at varying doses because tumor cells express survival factors with a wide degree of individual cell variability.

    There is a tactic of using biopsied cells to predict which cancer treatments will work best for the patient, by taking pieces of live “fresh” tumor tissue, applying different chemotherapy treatments to it, and examining the results to see which drug or combination of drugs does the best job killing the tumor cells. A cell-based assay test with “functional profiling,” using a cell-death endpoint, can help see what treatments will not have the best opportunity of being successful (resistant) and identify drugs that have the best opportunity of being successful (sensitive).

    Funtional profiling measures the response of the tumor cells to drug exposure. Following this exposure, they measure both cell metabolism and cell morphology. The integrated effect of the drugs on the whole cell, resulting in a cellular response to the drug, measuring the interaction of the entire genome. No matter which genes are being affected, functional profiling is measuring them through the surrogate of measuring if the cell is alive or dead.

    For example, the epidermal growth factor receptor (EGFR) is a protein on the surface of a cell. EGFR-inhibiting drugs certainly do target specific genes, but even knowing what genes the drugs target doesn’t tell you the whole story. Both Iressa and Tarceva target EGFR protein-tyrosine kinases. But all the EGFR mutation or amplificaton studies can tell us is whether or not the cells are potentially susceptible to this mechanism of attack. They don’t tell you if Iressa is better or worse than Tarceva or other drugs which may target this. There are differences. The drugs have to get inside the cells in order to target anything. So, in different tumors, either Iressa or Tarceva might get in better or worse than the other. And the drugs may also be inactivated at different rates, also contributing to sensitivity versus resistance.

    As an example of this testing, researchers have tested how well a pancreatic cancer patient can be treated successfully with a combination of drugs commonly used to fight lung, pancreatic, breast, and colorectal cancers. The pre-test can report prospectively to a physician specifically which chemotherapy agent would benefit a cancer patient. Drug sensitivity profiles differ significantly among cancer patients even when diagnosed with the same cancer.

    The funtional profiling technique makes the statistically significant association between prospectively reported test results and patient survival. It can correlate test results that are obtained in the lab and reported to physicians prior to patient treatment, with significantly longer or shorter overall patient survival depending upon whether the drug was found to be effective or ineffective at killing the patient’s tumor cells in the laboratory.

    This could help solve the problem of knowing which patients can tolerate costly new treatments and their harmful side effects. These “smart” drugs are a really exciting element of cancer medicine, but do not work for everyone, and a pre-test to determine the efficacy of these drugs in a patient could be the first crucial step in personalizing treatment to the individual.

    Literature Citation:

    Weisenthal, L.M. Functional profiling with cell culture-based assays for kinase and anti-angiogenic agents Eur J Clin Invest 37 (suppl. 1):60, 2007

    Nagourney, R.A. Functional Profiling of Human Tumors in Primary Culture: A Platform for Drug Discovery and Therapy Selection (AACR: Apr 2008-AB-1546)

  5. Exciting ovarian cancer breakthrough at the BC Cancer Agency « BC Cancer Foundation’s Blog Says:

    […] of the next-generation DNA sequencers and their ability to impact medicine – similar to what I blogged about recently on personalized medicine.  Second of all, it’s going to impact how we diagnose and treat people […]

  6. Carmine Fromdahl Says:

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  7. New hope for lung cancer patients « BC Cancer Foundation’s Blog Says:

    […] is another big step towards truly personalized medicine and gives us all reason for optimism for the future of cancer care.  But we still have a long way […]

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