Posted by Brigham and Women's Hospital November 20, 2013
The goal of personalized medicine is to match a treatment to the unique characteristics of an individual patient: his or her personal and family medical history, age, body size and other physical characteristics, and medical test results. But fundamentally, it is the DNA blueprint within cells that strongly influences a person’s risks of disease, how illnesses play out, and which drugs are likely to be most effective and with the fewest side effects. This is where the newest phase of personalized medicine is heading.
Today, the power of genomics and other DNA tools to uncover molecular patterns in the cells of patients – or in cancer patients, in the cells of their tumors – offers the potential to deliver precision treatment with maximum effect and safety. These molecular patterns reflect differences in the activity of genes and proteins, or abnormal changes, such as mutations, in the DNA code of genes that increasingly are being used to select the best treatment.
Researchers envision a future in which doctors could routinely prescribe “the right drug in the right dose to the right patient” initially, instead of experimenting with one treatment after another. The results could be less wasted time, expense, and health complications caused by adverse side effects. Genomic information can also help doctors make more accurate prognoses and better estimates of disease risks.
With a massive cancer genome research project called Profile, scientists at Brigham and Women’s Hospital and Dana-Farber Cancer Institute are building one of the world’s largest databases of genetic abnormalities in cancer, a resource that will make possible a wealth of studies on the genetic roots of the disease. Every patient at Dana-Farber/Brigham and Women’s Cancer Center and pediatric cancer patients treated at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center is offered the opportunity to participate in the study. To date, nearly 20,000 have consented.
For each participating patient, Profile scientists are analyzing DNA samples of their cancers through a new “next-generation” sequencing technology that scans cancer-related genes for mutations and other DNA alterations. From the results of these scans, pathologists can determine the particular set of abnormalities that are driving the cancer – a personalized tumor profile. More than 5,000 individualized tumor profiles have been generated by the project in its first two years.
Because these profiles reveal the fundamental molecular causes of a cancer, they may be more important in guiding treatment than standard classification based on where the tumors develop – breast, colon, lung. Personalized treatments guided by the molecular traits of a tumor are at an early stage. To fulfill the promise of this approach, scientists need to amass huge amounts of data linking DNA alterations to tumors’ behavior and how they respond to specific drugs. As one of the largest research efforts to do this, Profile is expected to be a major contributor to the future of cancer care.
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This post originally appeared on Insight, the blog of Dana-Farber Cancer Institute.