Every cancer, like every patient, is different. Genomic tumor assessments help identify the DNA alterations that are driving the growth of a particular tumor. As we understand more about these gene mutations, we are better able to provide cancer treatment therapies that specifically target changes in the tumor's genomic profile. Information about genomic changes that are unique to your individual cancer may help us determine treatments that may be appropriate for you. It's the promise of precision cancer treatment—a focus on the individual tumor in the individual patient.
Since genomic testing may not be right for every patient, your oncologist will help determine if you are a good candidate for the assessments.
Evolution of care
For centuries, scientists have been searching for better ways to treat cancer. The development of radiation therapy in the early 1900s and chemotherapy in the 1940s were two milestones. But both had significant drawbacks.
Early chemotherapy drugs lacked the selective capacity to distinguish between cancer cells and normal cells, resulting in toxic and sometimes intolerable side effects for patients. Radiation therapy initially was shown to cause cancer in addition to treating it.
Thanks to medical advances, both therapies have become more targeted, and researchers have found ways to minimize side effects. Today, radiation therapy and chemotherapy are considered the standard of care in treating cancer patients, helping millions of survivors to live longer.
The future is here
But these therapies still have limitations. For example, two patients displaying symptoms and imaging results associated with a certain cancer might be prescribed the same chemotherapy regimen, only to experience drastically different outcomes. Why? Because the root cause of their disease and the treatment needed are different, as is the molecular makeup of their individual tumor.
The Human Genome Project, completed in 2003, marked a dramatic shift in the understanding of cancer and other diseases. After 13 years, researchers mapped the entire human genetic code, discovering that every human cell is packed with an estimated 20,000 to 30,000 genes. Researchers have used the discoveries to link dozens of diseases, such as Alzheimer’s disease and inherited colon cancer, to specific genes.
In the case of cancer, researchers have discovered that two genes, BRCA1 and BRCA2, are associated with breast and ovarian cancers. Likewise, researchers have developed a drug specifically to treat breast cancers that demonstrate an overproduction of the protein HER2. Such drugs, now standard in the treatment of breast, ovarian, lung and some other cancers, target inherited genetic abnormalities identified through genetic tests, which detect mutations passed down from one generation to the next.
In recent years, the medical world has taken the advancements one step further, with genomic tests of the cancer itself. These even more targeted assessments study the DNA profile of the patient’s tumor, searching for genetic abnormalities that can be matched to a particular drug therapy that may not have otherwise been considered.
“This is an incredibly powerful, positive force in medical care. We were in the Dark Ages before this,” Dr. Maurie Markman, President of Medicine and Science at Cancer Treatment Centers of America® (CTCA), says of advanced genomic testing. “It is the tsunami on our shores, and it’s going to take over all of medicine. It is the future of cancer care, no question about it.”