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Our bodies are made up of trillions of cells, and within
each cell are genes. Genes contain
specific information that determines many of our traits, such as eye color,
skin color and height. Yet even beyond physical characteristics, researchers
have discovered that genes also play a role in our health and how diseases,
including cancer, develop within the body. This has led to a new approach to
medicine, known as precision medicine, where medical decisions and treatments
are guided by each individual’s genetic make-up.
Precision medicine helps create personalized cancer treatments.
Two people with the same “type” of cancer can have very
different outcomes. One person’s cancer may grow bigger, spread faster, or may
not respond to a treatment that worked for the other person. Why is this the
case?
Simply put, cancer occurs when abnormal cells in our body
grow out of control. This abnormal growth is often the result of mutations, or
changes, within specific genes. As researchers have studied this process,
they’ve found that many different combinations of mutations can occur, and
cancer is not “one-size-fits all”, even when it originates from the same part
of the body.
This discovery provided researchers with some powerful
information. Once mutations in the cancer cells were identified, treatments
were developed to target cells with those abnormal changes and stop the cancer
from progressing. This is called targeted therapy, and it is the crux of
precision medicine. Now doctors can analyze a patient’s tumor and look for the
genetic changes that are present. Instead of following a universal treatment
plan because a patient has breast cancer or lung cancer for example, a
treatment may be selected that works best for the specific tumor cell mutations
that are seen in an individual patient.
Precision medicine has multiple benefits.
In addition to helping select the most effective treatment,
there are other benefits of precision medicine:
-
It allows for more accurate diagnoses of cancer
(and other diseases). -
It helps patients avoid unnecessary treatments
and therefore, potentially harmful risks or side effects. -
It can help identify patients who may be at risk
for certain types of cancer, like those who have the BRCA-mutation and are at a
higher risk for developing breast cancer, so that interventions may be
performed to lower the risk. -
It may also take non-genetic characteristics,
like lifestyle and environment, into consideration since they impact disease
and treatment outcomes.
The Precision Medicine Initiative was launched to advance this field.
In his 2015 State of the Union address, President Obama
announced the launch of the Precision Medicine Initiative and Congress funded $215
million dollars to advance research and development in the area. It aims to
boost precision medicine across the board, but much emphasis will be placed on
cancer. The Initiative is designed to:
-
Create more clinical trials for precision
medicine to lead to better treatment options for cancer -
Learn more about why some tumors become
resistant to treatment -
Collect genetic data, samples, and health
information from at least 1 million volunteers -
Develop a national database to consolidate this
information for researchers and health care providers -
Use this information to construct models that
predict how different cancer cells will respond to treatment
Precision
medicine has come a long way, but we still have a lot to learn. Not every type
of cancer has a targeted therapy available to treat it, and some doctors simply
don’t have precision medicine technology available within their practices. At
this time, standard treatments for cancer, like radiation and chemotherapy, are
still the norm. Yet with the early successes we have seen, if you have cancer,
ask your doctor if genetic testing and precision medicine are appropriate for
you.