What You Need to Know About Cancer Genomics
We’re used to hearing about cancer in relation to a specific part of the body such as breast, lung or prostate, and treatments thus far have often been targeted to destroy tumor cells according to their location. New advances have improved our knowledge of the inner workings of cells, and once again we are witnessing a paradigm shift in how we could treat cancer in the future: from treatments that target the site of the tumor, to precision medicine which is more tailored to the individual patient group.
1. Every patient’s cancer is as unique as their DNA
Cells are the basic building blocks of the human body. The disease which we know and refer to as cancer is in fact a group of hundreds of different conditions. Cancer is increasingly being understood as a disease of the genome. Today, scientists and doctors recognize that no two cancers are alike; cancer is complex and varied. Just as each person’s genetic material is unique, so is every patient’s cancer.
When an abnormal change to genes occurs, this can lead to an alteration of proteins which are important for a healthy and functioning cell. As a result, these altered proteins drive the growth and spread of tumors – they are called “oncogenic drivers”. In cases where such an oncogenic driver exists, scientists can identify exactly why a cancer forms and acts in a specific way.
2. Precision oncology identifies the genetic makeup of a tumor
An important area of cancer research looks at how we can target oncogenic drivers on a molecular level. This new, emerging mode of treatment is called “precision oncology ”. Precision oncology tailors treatments to the underlying cause of an individual cancer patient’s disease.
Understanding the genomic make-up of a patient’s cancer and how this contributes to the severity of the disease is an important part of our research at Bayer. Together with Loxo Oncology, a Connecticut-based biopharmaceutical company, we are exploring ways to treat certain genetically-driven cancers. One such example is tropomyosin receptor kinase (TRK) fusion cancer – an overall rare disease, but one that occurs in a broad range of tumors in both adults and children. TRK fusion cancer is the result of an abnormal fusion of two genes in the cell, which leads to the creation of the NTRK gene fusion and ultimately, the growth of the cancer.
3. Genomic testing identifies what’s unique about a tumor
Genomic testing helps to identify DNA alterations that drive the growth of a cancerous tumor3 . By carrying out specific genomic tests, doctors and researchers may be able to more accurately predict which treatments will work in which specific groups of cancer patients. This could ultimately lead to receiving more effective therapies with fewer side effects.
4. Precision medicine treats cancer based on its genomic makeup
One of tomorrow’s potential cancer cures that researchers in academic institutions and the industry are working on today is a treatment that stops oncogenic drivers of cancer at the molecular level. Specifically designed precision medicines may be able to block these oncogenic drivers in cells no matter where the tumor is located in the human body. This is a major turning point in not only the way we treat cancer but also in how we can improve results for patients.
Studies have shown that between 30-49 percent of all patients who take part in genomic testing could be matched to a treatment that targets their specific genomic alteration4,5 . This is hugely promising for patients and, from a societal perspective, system changes are necessary so that cancer patients have access to the possibility of genomic testing and, subsequently, to precision treatments.
So, while we might still refer to breast, lung or prostate cancer in the future, the way we treat it could be markedly different.
1 National Cancer Institute, NCI Dictionary of Cancer Terms: Genome, Last accessed October 2018
2 National Cancer Institute, NCI Dictionary of Cancer Terms: Oncology, Last accessed October 2018
3 Cancer Center, Cancer Genomics, Last accessed September 2018
4 Boland GM, Piha-Paul SA, Subbiah V, et al. Clinical next generation sequencing to identify actionable aberrations in a phase I program. Oncotarget.
5 2015;6(24):20099-20110. Massard C, Michiels S, Ferte C, et al. High-throughput genomics and clinical outcome in hard-to-treat advanced cancers: results of the MOSCATO 01 trial. Cancer Discovery. 2017;7(6):586-595.