This is an exciting time in cancer research and treatment because we know much more about both the genetics and immunology that drive the disease than even 10 years ago, and that allows doctors to develop very specific treatment plans for individual patients. One of the most important tools in this process is next-generation sequencing (NGS) technology.
A new frontier
NGS helps us to identify and measure the genetic alterations that may be driving the growth of a patient’s tumor. With this specific knowledge the patient’s doctor can prescribe medication that attacks that mutation and shuts it down — a form of treatment known as targeted therapy.
Thus, we are attacking not the specific type of cancer — such as melanoma or colon cancer — but the genetic mutation driving it. It’s a different way of thinking about cancer that will profoundly affect drug development and approval.
Liquid biopsy is a new genetic test of cancer DNA from a blood sample that either provides an early warning that a patient is not responding to treatment or that treatment resistance is setting in, allowing the doctor to change plans preemptively.
Immunotherapy is revolutionizing cancer care today. Former President Jimmy Carter’s melanoma is in remission thanks to immunotherapy. However, not all cancer patients are good candidates. NGS can help determine if the patient might respond. If not, other options can be used.
One new trend in immunotherapy is individualized cancer vaccines, designed using the results of tumor genetics to focus the patient’s immune response to their cancer cells. Vaccines will be particularly valuable in difficult-to-treat cancers such as glioblastoma and pancreas cancers.
The future of research
Several efforts are being made to feed the details of specific mutations in genes, the individualized treatments that are used and the patient outcomes (with the necessary protection for patient privacy) into computer databases, with the goal of sharing information to help more patients and clinicians make treatment choices. Project GENIE, led by the American Association for Cancer Research, is one such database.
It’s a new day in cancer research and treatment. Powerful technology is helping us crack secrets cancer has held too long. It’s uncertain that we can get rid of cancer, but hopefully we can transform it into a treatable disease that people can live with for a long time.