The New York Times recently ran a three part series titled “Genetic Gamble – New Approaches to Fighting Cancer.” The series featured three stories where genetic sequencing had been used to create a personalized treatment plan for patients.
The first was a compelling story about a group of genetic researchers at Washington University who discovered that one of their colleagues, Dr. Wartman, had been diagnosed with leukemia. They decided to utilize the University’s genome institute to search for a clue to stop the cancer. They sequenced the genes of Dr. Wartman and healthy cells for comparison coupled with an analysis of his RNA. They discovered that a normal gene was producing large amounts of a protein that was causing the cancer’s growth. Dr. Wartman was also lucky to learn that a new drug approved for advanced kidney cancer would stop the malfunctioning gene. He began taking the drug and now his cancer is in remission.
Dr. Wartman’s success story is by no means an indication that all cancers can be helped with genetic sequencing, in fact the next story in the three part series, was sadly an example where personalized treatment did not work. However, Dr. Wartman’s story does highlight the potential of personalized treatment and also perhaps a growing shift in the way new drugs are discovered. This novel approach to cancer affords the opportunity to examine each case of cancer at an individual level. What is making this cancer tick in this person? While there are many drugs that have been successful against a certain type of cancer for a large group of patients, there are always some patients that don’t respond to the treatment as expected. Could genetic sequencing be an opportunity to treat these individuals? Could this technology also be employed to help others with rare forms of cancer for which there is currently no other treatment options?
The answers to these questions are still up for debate. Also unclear is when this type of treatment could be available and whether insurance companies would pay for it. There is hope though, due to the drop in cost of genetic sequencing and the innovations that have led to smaller sequencing machines, moving this technology from the lab to a clinical setting is becoming a possibility. In a recent blog “Genetic Sequencing – 3 ways it will enable a new future for medicine,” we discussed the transition from the lab to the clinical setting for genetic sequencers. The move from lab to the clinic is only possible because companies like Illumina and Life Technologies have introduced genome sequencing machines that are smaller and easier to operate. These new machines are roughly the size of a desktop printer and are relatively affordable. Perhaps even more important is that these sequencers are now able to sequence a genome in a day. After the genome is sequenced, a team of researchers needs to look for the mutations and be able to identify any differences between diseased and healthy genomes.
As the New York Times article states “With a steep drop in the costs of sequencing and an explosion of research on genes, medical experts expect that genetic analyses of cancers will become routine. Just as pathologists do blood cultures to decide which antibiotics will stop a patient’s bacterial infection, so will genome sequencing determine which drugs might stop a cancer.” I certainly hope that this is true, but even if this is a long time in the future, researchers are empowered with more information then ever before. Hopefully this will inform new drug discoveries that will help many people survive cancer in the future.
As Dr. Timothy Ley, Associate Director of the Washington University’s Genome Institute stated “Until you know what is driving a patient’s cancer, you really don’t have any chance of getting it right.” He went on to say, “For the past 40 years, we have been sending generals into battle without a map of the battlefield. What we are doing now is building the map.”