Personalized Medicine in Cancer: What does it mean and how is it done?

Summary

The Sement Cancer Center, in collaboration with Washington University's Genomics and Pathology Services (GPS), is utilizing Next Generation sequencing to revolutionize cancer treatment. By decoding tumor DNA, doctors can pinpoint genetic mutations driving cancer, allowing for precise, personalized therapies. This approach, known as tumor profiling, enables more accurate diagnoses and targeted treatments, improving patient outcomes. One case highlights a woman with advanced lung cancer whose tailored treatment led to a dramatic response. This breakthrough is transforming cancer care, moving towards a future where even aggressive cancers can be managed effectively.

Takeaways

• 🧬 The Siteman Cancer Center and Washington University's genomics and pathology services (GPS) are utilizing genome decoding to achieve life-changing outcomes for cancer patients.
• 🧪 Next Generation sequencing helps doctors personalize cancer treatments by analyzing patients' tumor DNA.
• 📊 Cancer results from multiple genetic changes that can be inherited or acquired through exposure to toxins, UV light, or other environmental factors.
• 🔍 85% of cancers are due to genetic changes acquired over time, explaining why it often takes years for cancer to develop.
• 💡 Sequencing tumor DNA allows doctors to understand the specific genetic changes causing cancer, leading to personalized treatment plans.
• 💉 Personalized medicine can target genetic mutations with specific drugs, enhancing treatment outcomes beyond the tumor's location.
• 🧠 Tumor profiling using Next Generation sequencing allows the analysis of numerous cancer-related genes simultaneously, helping to understand tumor behavior and aggressiveness.
• 🧑‍⚕️ Patients like Sue, diagnosed with stage 4 non-small cell lung cancer, benefit from molecularly targeted therapies, which can significantly shrink or eliminate tumors.
• 🏥 GPS's tumor profiling results help doctors diagnose and manage cancer more effectively, improving survival rates and quality of life for patients.
• 🚀 The future of cancer treatment lies in individualized therapies based on tumor DNA, where even aggressive cancers could become manageable chronic diseases.

Q & A

What is the Siteman Cancer Center doing in partnership with Washington University's Genomics and Pathology Services (GPS)?

The Siteman Cancer Center, in partnership with Washington University's Genomics and Pathology Services (GPS), is using advancements from the Human Genome Project to apply next-generation sequencing techniques to develop personalized treatment plans for cancer patients.

What is Next-Generation Sequencing (NGS), and why is it significant in cancer treatment?

Next-Generation Sequencing (NGS) is a technology that enables the analysis of dozens, hundreds, or even thousands of cancer-related genes at the same time. It provides detailed information about the genetic makeup of a tumor, allowing doctors to create personalized treatment plans based on the unique genetic mutations present in the cancer cells.

How does cancer develop according to the script?

Cancer develops when a series of genetic changes, which can be inherited or acquired over time, cause cells to lose their normal function. These changes result in cells growing and dividing uncontrollably, forming a tumor. Approximately 85% of all cancers are caused by acquired genetic mutations due to factors like aging, exposure to cigarette smoke, toxic chemicals, or UV light.

What is tumor profiling, and how does it benefit cancer treatment?

Tumor profiling involves using NGS to read the DNA sequence of a tumor, providing a high-resolution view of its genetic code. This allows doctors to identify specific genetic changes that contribute to the cancer's development, enabling them to tailor treatments that target these mutations, improving patient outcomes.

What impact did tumor profiling have on the patient named Sue?

Sue, a stage four non-small cell lung cancer patient, benefited from targeted Next-Generation Sequencing, which identified a specific genetic mutation. This discovery enabled her to receive a treatment as part of a clinical trial, resulting in a significant reduction in tumor size and improved quality of life.

What are the sources of genetic changes that can lead to cancer?

Genetic changes that lead to cancer can be inherited or acquired. Acquired changes are more common and often result from exposure to external factors like cigarette smoke, certain toxic chemicals, or UV light from the sun, as well as natural changes that occur as we age.

Why is tumor profiling considered a 'GameChanger' for oncology?

Tumor profiling allows doctors to treat patients based on the genetic makeup of their tumors rather than just the location of the tumor in the body. This personalized approach can identify treatments that are more effective and have fewer side effects, making it a significant advancement in cancer care.

How has the Human Genome Project contributed to cancer research?

The Human Genome Project provided the foundational knowledge of the human genetic code, enabling researchers to understand genetic mutations in cancer cells. This understanding has been translated into practical applications, such as Next-Generation Sequencing, to create personalized cancer treatments.

What does it mean for a patient to have a 'complete response' to cancer treatment?

A 'complete response' means that the patient's cancer has significantly regressed or disappeared as a result of the treatment. In Sue's case, her metastasized tumors disappeared, and her original tumor shrank after receiving targeted therapy.

What is the future vision for cancer treatment according to the script?

The future vision for cancer treatment involves using tumor DNA sequencing to transform cancer into a well-managed chronic disease. By treating each cancer patient based on the genetic profile of their tumor, doctors aim to provide precise, effective treatments that improve survival and quality of life.

Outlines

00:00

🔬 Partnership for Personalized Cancer Treatment

This paragraph introduces the collaboration between Sement Cancer Center and Washington University's Genomics and Pathology Services (GPS). It highlights the use of knowledge gained from decoding the human genome to improve cancer treatments. GPS uses Next Generation Sequencing (NGS) to make personalized medicine a reality for cancer patients. By analyzing a patient’s genetic code, doctors can tailor treatments specifically to the individual's cancer characteristics.

05:03

🧬 Understanding DNA and Cancer Development

This section explains how the human body, made of trillions of cells, relies on DNA as its genetic blueprint. Cancer occurs when genetic changes accumulate in DNA, either inherited or acquired over time due to environmental exposures like cigarette smoke and UV light. As people age, these mutations increase, and cancer arises when the right combination of changes causes cells to malfunction, grow uncontrollably, and form tumors.

🔍 Tumor DNA Profiling: A New Frontier in Cancer Treatment

In this paragraph, the benefits of decoding the DNA sequence of tumors are discussed. If doctors can identify the genetic changes in a tumor, they can design more precise treatment plans, targeting specific mutations with tailored drugs. Next Generation Sequencing allows for comprehensive analysis of cancer-related genes, offering detailed insights into the tumor's DNA, enabling personalized cancer management.

💊 How Personalized Treatment Changes Lives

This section highlights the application of Next Generation Sequencing to treat patients more effectively. The story of Sue, a cancer patient with stage four non-small cell lung cancer, demonstrates the power of tumor profiling. Targeted therapy based on her genetic mutation significantly improved her health, leading to tumor reduction and improved quality of life. Personalized medicine is bringing significant benefits to patients, improving survival and treatment outcomes.

🚀 The Future of Cancer Treatment

The final paragraph focuses on the evolving approach to cancer treatment, where cancer is no longer viewed as a single disease but as a collection of disorders with unique genetic profiles. By sequencing and analyzing tumor DNA, doctors can predict the behavior of different cancers and develop more effective, personalized treatments. The goal is to manage even aggressive cancers as chronic conditions, and this future of cancer care is already underway.

Keywords

💡Next Generation Sequencing

Next Generation Sequencing (NGS) refers to advanced techniques that allow scientists to analyze large quantities of genetic data quickly and efficiently. In the video, NGS is used to decode the DNA of tumors, providing a detailed understanding of their genetic makeup. This technology is essential in the shift toward personalized cancer treatment, as it helps identify mutations that can be targeted with specific drugs.

💡Personalized Medicine

Personalized medicine is an approach to treatment that tailors therapies to an individual's unique genetic profile. In the context of the video, personalized medicine is made possible by tumor profiling and NGS, allowing doctors to create custom treatment plans based on the genetic alterations of a patient's cancer, rather than using a one-size-fits-all approach.

💡Tumor Profiling

Tumor profiling involves analyzing the genetic changes within a tumor to identify mutations that have contributed to its development. The video highlights how this process, using Next Generation Sequencing, allows doctors to see the DNA code of the tumor, helping them determine the most effective treatment based on the tumor's specific genetic characteristics.

💡Genetic Mutation

A genetic mutation is a change in the DNA sequence that can occur naturally or due to environmental factors. In the video, genetic mutations are the cause of cancer, as certain combinations of these changes lead to uncontrolled cell growth. Understanding these mutations is key to developing targeted therapies.

💡Human Genome Project

The Human Genome Project was an international research effort to map all the genes in the human genome. The video references this project as a foundation for current advances in cancer treatment, particularly in using genomic data to inform personalized medicine. It paved the way for technologies like Next Generation Sequencing.

💡Targeted Therapy

Targeted therapy is a cancer treatment that specifically targets the genetic mutations driving tumor growth. In the video, targeted therapy is shown to have transformed the treatment landscape, as patients like 'Sue' benefit from drugs designed to attack the specific mutations found in their tumors through tumor profiling.

💡Cancer Cells

Cancer cells are abnormal cells that grow uncontrollably due to mutations in their DNA. The video explains that cancer develops when these cells lose their normal function and form tumors. Analyzing the DNA of these cells through tumor profiling helps doctors determine how to treat them effectively.

💡Metastasized Tumor

A metastasized tumor is a tumor that has spread from its original location to other parts of the body. In the video, Sue's non-small cell lung cancer had metastasized, but targeted therapy helped shrink both the original and the metastasized tumors, illustrating how personalized medicine can improve outcomes even in advanced cancer.

💡Clinical Trial

A clinical trial is a research study that tests new treatments to determine their effectiveness and safety. The video mentions that Sue participated in a clinical trial for a drug targeting her specific genetic mutation, which successfully treated her cancer. This highlights the importance of clinical trials in advancing personalized medicine.

💡Tumor DNA

Tumor DNA refers to the genetic material within cancer cells that contains mutations leading to cancer. In the video, tumor profiling through Next Generation Sequencing allows doctors to read the DNA of tumors, identifying genetic changes that can be targeted by specific drugs, thereby tailoring treatment to the patient's unique cancer profile.

Highlights

The partnership between Sement Cancer Center and Washington University's Genomics and Pathology Services (GPS) focuses on translating genomic research into life-changing outcomes for cancer patients.

GPS builds on the Human Genome Project to use Next Generation Sequencing (NGS) for personalized medicine in cancer treatment.

Cancer occurs due to genetic changes in the DNA of cells, with 85% of cases caused by changes acquired over a lifetime, such as from smoking or UV exposure.

NGS allows doctors to analyze dozens to thousands of cancer-related genes simultaneously, providing a more detailed tumor profile.

Tumor profiling with NGS can identify specific genetic changes that have caused a tumor to develop, helping doctors personalize treatment plans.

Personalized medicine can target specific genetic mutations in cancer cells, rather than just the tumor’s location in the body.

Sue, a patient with stage 4 non-small cell lung cancer, benefited from targeted NGS, revealing a gene mutation that allowed her to participate in a clinical trial with successful outcomes.

Sue's metastasized tumors disappeared, and her original tumor shrank after targeted therapy, showcasing the impact of personalized treatments.

Molecularly targeted therapy has brought personalized cancer treatments closer to reality, significantly improving patients' quality of life and survival rates.

Next Generation Sequencing results help doctors not only diagnose cancer more accurately but also predict how aggressive the tumor might be.

Doctors no longer treat cancer as a single disease, but rather sequence each tumor's DNA to reveal its unique characteristics and optimal treatment.

Personalized therapies based on tumor DNA profiling are changing oncology by treating cancer as a well-managed chronic disease.

GPS's tumor profiling with NGS is revolutionizing cancer care by making treatment plans more precise and cost-effective.

The future of cancer treatment focuses on managing aggressive cancers with personalized therapies, and this future is already in progress.

Patients with targetable molecular alterations are experiencing significant improvements in both quality of life and survival thanks to personalized treatments.

Transcripts

[Music]

the sement cancer center in partnership

with Washington University's genomics

and pathology Services known as GPS is

taking what was learned from decoding

the human genome and translating it into

life-changing outcomes for cancer

patients building on the Human Genome

Project a massive effort involving

Laboratories across the globe and

including Washington University's genome

Institute the GP s team is using

so-called Next Generation sequencing to

help doctors in making personalized

medicine a reality for their cancer

patients but what does that mean and how

does it

work the human body is made up of more

than 30 trillion cells and each of those

cells contains DNA our genetic code when

cancer occurs something in our cell's

DNA has gone wrong a genetic change it

takes more than just one genetic change

to result in cancer and these changes

can be inherited or more commonly

acquired after we are born in fact 85%

of all cancers happen as a result of

changes that occur over the course of

Our Lives by exposure to things like

cigarette smoke certain toxic chemicals

or UV light from the sun as we age our

cell's DNA gets more and more of these

changes which explains why it may take

many years for a cancer to develop

cancer occurs when certain combinations

of these changes cause cells to lose

their normal function as a result they

grow and divide uncontrollably and

together they form what we call a

tumor imagine if we knew how to read the

DNA sequence of a tumor we could then

see where the genetic changes are what

they look like and what they do having

that kind of information would mean

doctors could provide a precise

personalized management plan for for

patients with cancer perhaps even

targeting some of the genetic changes

with specific

drugs together with the GPS team seyman

cancer center physicians are using

revolutionary new ways to determine the

genetic makeup of cancer cells more

quickly and inexpensively than ever

before next Generation sequencing allows

us to look at and analyze dozens

hundreds or even thousands of cancer

related genes all at the same time this

so-called tumor profiling provides the

unique genetic information for a

specific cancer we can see with

incredibly high resolution the actual

code of a tumor's DNA and in many cases

we can identify specific changes that

have played a role in the development of

that tumor armed with that kind of

information we are literally changing

the future for our cancer patients they

can be treated individually with drugs

that specifically Target their tumor

cells based on its genetic code not just

based on where the tumor is in their

body or where it may have Arisen this is

a GameChanger for oncology it's really

very

[Music]

exciting tumor profiling by Next

Generation sequencing done at GPS is

changing the way doctors manage their

cancer patients results can help

diagnose a tumor more specifically or

give doctors clues about how aggressive

a cancer will be Sue is a great example

of how results from tumor profiling may

impact treatment and improve outcomes

she was diagnosed with stage four non-s

small cell lung cancer and benefited

from chemotherapy for some time but then

developed worsening shortness of breath

and cough due to spread of her cancer I

knew before I even had the CT that there

was something wrong because I was

coughing a lot and my shortness of

breath had come back so you know you

could tell you could tell that there was

something we performed targeted Next

Generation sequencing of her tumor which

revealed a gen mutation for which she

received treatment as part of a clinical

trial it just so happened that there was

a study being done at San for that exact

mutation so I volunteered to be in that

study and it has been very successful

for me the metastasized tumors

disappeared right away and then after

that the original tumor actually shrank

and and so I'm having what's called a

complete response the Advent of of

molecularly targeted therapy has helped

us to move one step closer towards

realizing our dream of personalized

therapy for patients with cancer for

patients in whom we find a targetable

molecular alteration this can mean

significant Improvement in their quality

of life as well as their outcome in

survival I can live my life in in just a

very normal way my husband and I walk I

Garden I take care of my grandson from

time to time all of the normal things

that anyone would do I feel like I have

been very

fortunate we no longer think of cancer

as a single disease anymore and we don't

even think about treating patients with

a given tumor type using the same

therapy rather we are individually

sequencing and reading the tumor DNA to

reveal not only what type of cancer it

might be but how it is likely to behave

and how it is best treated we look

toward a future where even the most

aggressive cancers become a well-managed

chronic disease and the good news is

that future is already

underway for more information on tumor

profiling by Next Generation sequencing

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