Targeted Cancer Care

Targeted Cancer Care:

Targeting the Unique Changes in an Individual's Cancer

Cancer affects millions of individuals and each individual's cancer is unique. Even though cancers can be grouped by site of origin (e.g. breast cancer, prostate cancer), scientists have shown that each person's cancer has different abnormalities. Great progress has been made in developing technologies that can help identify the cellular and molecular differences in cancer cells. In recent years, projects like the Cancer Genome Atlas have helped identify thousands of mutations in cancer cells that drive the disease. The fact that each cancer patient may have different combinations of these abnormalities has led to a revolution in how we fight the disease.

The field of oncology is realizing that the best way to approach treating cancer may be to focus on drugs and therapies that attack specific gene abnormalities. For example, in the past, if a woman was diagnosed with breast cancer, she received the same treatment as most other breast cancer patients, even though this "standard" treatment only worked for some of the women. This is no longer always the case. Through molecular testing, it is now possible to identify some of the unique genetic differences in each woman's cancer and utilize this information to make more individualized treatment decisions. Finding these molecular changes may be critical to providing more effective treatment strategies for patients with many different types of cancer. This approach to medicine is often called "personalized medicine".

A constantly increasing number of molecular-level tests are being developed that identify the "on" and "off" switches in each individual's disease. Because these "biological" switches can be identified and may "mark" a cell as cancerous, they are called 'biomarkers". The identification of more biomarkers is helping to pave the way for the development of hundreds of new drugs and many new therapies that seek to target specific molecular abnormalities.

There are many examples of biomarker/targeted drug pairings and it is likely that there will be many more discovered in the next decade that will lead to improved treatments for cancer patients. It is very important that these biomarkers and targeted drugs be tested in clinical trials, to ensure their safety and effectiveness. Many of these drugs are still in the process of testing through clinical trials and the trial may be the only way to access these treatments. Increasingly, doctors are using molecular testing to identify the specific characteristics of a patient's cancer to help the patients select or qualify for these clinical trials. While researchers still have a long way to go before understanding all of the pathways cancer takes in different patients, there is much hope that we are moving into a new era where cancer treatment is designed on a patient-to-patient basis rather than based on standard protocols or averages.