By Administrator at 16 Jan 2019, 09:59 AM
Tumors, just like our bodies, contain genes and other genetic material as a part of their DNA. A genome is an organism’s complete set of DNA. Genomics explores an organism’s behavior at the molecular level, studying how an organism forms and its potential for growth, change, and playing with others. Why does a cell go from being healthy to being destructive? What causes a cell to gravitate towards or away from other cells? What is the likelihood of the cell becoming aggressive and spreading? Will a cancerous tumor’s molecular structure enable it to evade, hide, or disguise to withstand attack from the immune system or resist treatments?
Genomics can help doctors identify a targeted therapy or treatment for individual patients based on the molecular components of a specific tumor. Patricia LoRusso, DO, of Yale University, is doing just that in her Gateway-funded trial “Genomics-Enabled Medicine for Melanoma (G.E.M.M.): Using Molecularly-Guided Therapy for Patients with BRAF wild-type (BRAFwt) Metastatic Melanoma.” In recent years, treatment advances have been made in the battle against metastatic melanoma by targeting the BRAF gene. For patients with BRAFwt, however, more research is needed to find effective treatments. This clinical trial led by LoRusso takes the approach of characterizing BRAFwt tumors to identify a molecularly informed therapeutic regimen for patients with BRAFwt metastatic melanoma. LoRusso and her team are evaluating over twenty treatment options that are known to target various genetic profiles.
Genomics in cancer research can also be used to tell one type of cancer from another. It goes beyond just asking how a tumor is structurally different from a healthy cell to how a molecular structure of one cancerous tumor differs from the molecular structure of another cancerous tumor. Utilizing the study of genomics to fight cancer in a precise, individualized, and targeted way is helping researchers, doctors, and patients find better treatment options and get better outcomes — together. Here are three ways that happens:
Knowing the Why
Knowing the why may be about the tumor itself — finding out the unique root causes of similar symptoms at a molecular level could explain why the same treatment is effective for one patient but not another. It may be about finally discovering why a treatment works so that doctors feel more comfortable in recommending that treatment. Or, it may be in understanding the uniqueness of a diagnosis. “Digging into that diagnosis [of a common or rare cancer classification] and helping patients learn about the unique molecular aspects of their tumor will help them better understand what they are dealing with and what questions to ask,” says Stephen Lynch, MD, Intake and Primary Care Physician at Cancer Treatment Centers of America® (CTCA), Arizona, in the blog post “Precision medicine is re-defining what makes a cancer rare or common.1”
Strengthening the Treatment
Genomics may also give researchers insight into different treatment combinations to explore that strengthen existing approaches or create stronger ones that can be tailored for individual patients. In 2017 article by Kat McGowen published on Business Insider, she writes: “This new breed of cancer vaccines should be more effective than its failed precursors. Applying mathematical analysis to genome sequence data, researchers hope to predict which weird changes to tumor cells may be good targets for a vaccine, and bundle many of them together into a potent mix that can fire up the immune system.2”
Expanding the Possibilities
In addition to identifying the “whys” and strengthening treatments, genomics can also expand possibilities in cancer research. One area that is beginning to happen is in the treatment of rare cancers. “We may be seeing treatments for rare cancers based on genomic analysis initially conducted on many common cancers or where the mutations are more commonly observed,” says Maurie Markman, MD, President of Medicine and Science for Cancer Treatment Centers of America® (CTCA) in the blog post “Precision medicine is re-defining what makes a cancer rare or common.1”
Gateway-funded trials involving genomics include melanoma, prostate cancer, bone marrow cancer, and pancreatic cancer, to name a few. Information about Gateway-funded trials can be found here, and a description and clinical summary of LoRusso’s BRAFwt Metastatic Melanoma study can be found here.
Learn more about genomics and its importance in cancer research at the Cancer Treatment Centers of America® (CTCA) website.
1 Cancer Treatment Centers of America. (2018, July 19). Precision medicine is redefining what makes a cancer rare or common [Blog post]. Retrieved from https://www.cancercenter.com/community/blog/2018/07/precision-medicine-is-redefining-what-makes-a-cancer-rare-or-common
2 McGowen, K. (2017, March 15). Scientists are adopting a new battle plan in the wage against cancer. Retrieved from https://www.businessinsider.com/scientists-are-adopting-a-new-battle-plan-in-the-war-against-cancer-2017-3
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