From OHC, Specialists in the Treatment of Adult Cancers and Blood Disorders
October 4, 2021
The 2017 FDA approval of Keytruda for patients whose cancers have specific genetic features was the first time the agency approved a cancer treatment based on a common biomarker rather than the location in the body where the tumor began to grow. Since then, the terms precision, personalized, or individualized medicine often refer to the method doctors use to determine which cancer therapy is best for an individual patient.
All cancers are caused by genetic mutations, or changes. Cells with too many mutations can grow out of control and become cancerous. “We now know that two patients with the same type of cancer might respond to treatment differently based on the individual molecular profile of their tumors,” said OHC’s Suzanne M. Partridge, MD, medical oncologist, hematologist, and principal investigator for OHC’s breast cancer and melanoma clinical trials. Fundamental to OHC’s patient care philosophy is the idea that there is not a one-size-fits-all approach to treatment and each patient’s cancer is unique. “Next-generation sequencing and precision medicine are additional tools in our arsenal allowing us to better provide care to patients for their specific cancer,” said Dr. Partridge.
Next-generation sequencing (NGS) helps doctors pinpoint genetic mutations in a tumor and predict a patient’s response to certain treatments. NGS compares the genes in a tumor to those of a normal, or reference, genome. Once the tumor’s genetic changes are discovered, a physician can select medicines that target those changes while limiting the impact on the rest of the body’s healthy cells. “Having this deeper understanding of the biological makeup of a patient’s tumor not only helps us to customize the best therapy for that individual, it can also help determine how aggressive our treatment strategy should be,” said Dr. Partridge. “Information gleaned from NGS can give us a better understanding of a patient’s prognosis and aid in the selection of a therapy that might be less harmful than standard chemotherapy and radiation. And, it’s believed that therapies targeted for specific genetic mutations increase survival and improve patient quality of life,” said Dr. Partridge.
As the number of targeted therapies and applicable genetic mutations increases, NGS should become the standard of care in the field of oncology. The Journal of Clinical Oncology, a journal of the American Society of Clinical Oncology, recently published the results of a retrospective analysis of 2,316 breast cancer patients who received NGS testing from 2014-2019. The results revealed that each year, more and more medical oncology physicians in community settings were using NGS in the care of their breast cancer patients. Specifically, over the duration of the study, NGS for breast cancer patients increased more than six-fold.
While doctors typically suggest NGS for patients with cancer that has spread or returned after treatment, all cancer patients should be comfortable discussing NGS with their doctors. “At OHC, part of creating a personalized treatment plan for every patient involves outlining goals and probable outcomes,” said Dr. Partridge. “Any physician recommending NGS for a patient should explain the procedure and the likelihood of finding a mutation that will respond to a targeted therapy or treatment being studied in a clinical trial.”
OHC is currently participating in the TAPISTRY (Tumor-Agnostic Precision Immuno-Oncology and Somatic Targeting Rational for You) trial to evaluate how genetic testing can help physicians select the best treatment for patients with advanced solid tumors that cannot be surgically removed. “While evaluating genetic mutations, some are irrelevant, but others are ‘driver’ mutations we can target with cancer treatment,” said Dr. Partridge. A driver mutation is a change that gives a cancer cell significant growth advantage. TAPISTRY will evaluate specific mutations and the safety and efficacy of various immunotherapies for treatment.Comments (0)