N=1: Truly individualized care
The traditional approach defines cancer, and its treatment, in a way that may one day prove outdated: by its location—cancer in the breast is breast cancer; cancer in the lung is lung cancer, etc. Cancer treatment has typically followed a similarly generalized line of attack. The norm has patients trying a few types of chemotherapy before the right combination is found. In recent years, though, researchers and physicians have found that a particular cancer in one patient doesn’t necessarily behave the same way in another patient. Some cancers even bear similarities to cancers that were once thought to be completely different. A breast tumor, for example, may look and act like a lung tumor. By looking at the tumor’s genetic profile with genomic testing, physicians may be able to recommend a drug or protocol not previously considered—like using a traditional breast cancer therapy to treat a lung tumor.
This shift in thought and approach is toward truly individualized care. Instead of one-size-fits-all medicine, which can lead to unnecessary and even harmful treatments for some patients, advanced genomic testing devotes its attention to studying a single individual—the patient whose tumor is being tested. It’s what researchers describe as the N=1 (“the N of one”), a study group with just one participant, with all efforts focused on attacking that patient’s tumor at its source: the mutations coded in its DNA.
Looking for a specific genetic abnormality in a tumor is not new—it’s the standard of care for patients with breast, lung, ovarian, colon and some other cancers. Advanced genomic testing takes the basic tumor test to the next level with state-of-the-art, gene-mapping analyses that may open up new options to patients with rare, unusual or hard-to-treat cancers and those whose tumors did not respond adequately to conventional therapies. Rather than treating cancer patients by their cancer type, stage and prior therapies, precision medicine digs deeper to the genetic level to find more appropriate treatment protocols. This more refined approach may lead to a day when cancer is no longer defined by where it’s located, but by its molecular structure.
It is important to emphasize, though, that precision cancer care is an evolving science. While the field is growing, there is still much to learn. Not all mutations can be matched with known treatment options, and advanced genomic testing is not appropriate for all patients. At a time when victory over cancer remains elusive, genomic tumor testing is a tool that may be used, today, to help doctors consider more precise therapies in the ongoing search for better treatment.