#genomic medicine

Molecular profiling is more often used after standard cancer treatments have failed, but a new study suggests that it could effectively guide first-line treatment, especially for poor-prognosis cancers

In treating cancer, personalized medicine means recognizing that the same disease can behave differently from one patient to another, and precision medicine means that diagnosis and treatment should involve understanding the specific genetic makeup of each patient’s tumor and disease.

In a recent study, published October 4, 2021 in Genome Medicine, researchers at University of California San Diego School of Medicine and Moores Cancer Center at UC San Diego Health, with colleagues elsewhere, report that conducting genomic evaluations of advanced malignancies can be effective in guiding first-line-of-treatment, rather than waiting until standard-of-care therapies have failed.

By their nature, cancers are molecularly complex, each with a heterogeneous combination of genetic mutations that, more often than not, defy easy treatment. With every stage and line of therapy, tumor cells adapt to become more resistant to remedy.

The study authors hypothesized that developing matched, individualized combination therapies for patients with advanced cancers who had not been previously treated might be feasible and effective.

Just under 150 adults with newly diagnosed cases of advance malignancies were enrolled in the prospective study at two sites: Moores Cancer Center and Avera Cancer Institute in Sioux Falls, South Dakota. The patients had either incurable, lethal cancers (at least a 50 percent cancer-associated mortality rate within two years) or they had a rare tumor with no approved therapies.

Researchers performed extensive genomic profiling of all patients, identifying and documenting all detectable gene mutations to create a molecular profile of each patient’s tumor that would guide their precision cancer therapy.

“Each patient received a personalized N-of-1 treatment plan that optimally matched therapeutic agents to their tumor’s distinct biology, while also taking into account other variables, such as underlying conditions or co-morbidities unique to that patient,” said first author Jason Sicklick, MD, professor of surgery at UC San Diego School of Medicine and surgical oncologist at Moores Cancer Center.

Pictured: Cancer cells ( Thomas Deerinck)

“At Initial Cancer Diagnosis, a Deeply Personalized Assessment”