Video: the personalized medicine revolution in cancer care

Cancer care is changing to become more individualized and personalized.  Detailed biologic analyses of individual cancers are increasingly enabling treatment to be tailored to match each cancer's unique vulnerabilities.  We wrote about this in a  prior blog post.  


Now, you can watch a great show about personalized cancer care from the OHSU Knight Cancer Institute.  Click here to see the show.  Some aspects are specific to the Knight Institute, but most of the program will help you learn about personalized and targeted therapy for cancer.


The call-in lines, by the way, are no longer open.  Folks could call in with questions on the day the show ran on KOIN-TV in Portland.


To put a smile on your face see Larry's latest cartoon.

To learn more about clinical trials, take a look at our book.
(c) 2012 Tom Beer and Larry Axmaker

Cancer therapy: from one-size-fits all to custom designed

     Most cancer treatment today can be described as “one size (hopefully) fits all.”  We try a “standard” drug in all patients with the same cancer.  Some patients get a lot of benefit from treatment, others very little or no benefit at all.  Some patients have severe side effects, others very few.  We find this out by trying medications and hoping for the best.  It often takes a couple of months of treatment before a cancer patient can know if the right treatment was chosen. 

         It is likely that, in the near future, a sample of an individual’s cancer will be carefully and extensively analyzed in the laboratory before any therapy is started. The results of this analysis will allow us to select a treatment that will likely work the first time.  By matching drugs to the specific defects in an individual human being’s cancer, we should be able to avoid the “trial and error” approaches of today.

         In 2011, two new cancer treatments were approved that illustrate this new paradigm. Crizotinib (Xalkori^®) was approved for the treatment of lung cancer that harbors a specific mutation in the ALK gene. Vemurafenib (Zelboraf^®) was approved for the treatment of melanoma, the deadliest form of skin cancer. This drug targets BRAF—a protein that is mutated in nearly half of melanomas and drives the cancer’s growth. Both of these drugs will only be helpful to people whose cancer carries the target mutation and that is why the drugs were approved together with a test to determine if an individual person's cancer is likely to be susceptible.  

     We will see many more such drug–test combinations, and they promise to bring much better results to cancer patients. The approval of these two drugs shows that the era of personalized medicine has begun to arrive. 

The big trends in medical treatments for cancer

Medications are the mainstay of treatment for those cancers that by their nature or because they have spread, cannot be removed surgically or eliminated with radiation.  Medical treatments are also often added to surgery or radiation to kill the few cancer cells that may have escaped and reduce the chance of cancer coming back.  The broad trends that are driving research into new medications for cancer include:

·        New chemotherapy drugs and combinations of drugs

·        New ways to manipulate the hormones that drive certain cancers (primarily breast and prostate cancer)

·        More specific and targeted therapies that are sometimes referred to as “smart bombs.”  These types of treatments are designed to attack very specific mechanisms that drive cancer growth and spread.  A variety of technologies make targeted therapy possible.  Some are artificial antibodies, synthetic small chemical molecules, and gene-directed therapies

·        Harnessing the immune system to fight cancer

·        All cancer therapy is likely to become more personalized (individualized) with treatments selected to match each person’s unique cancer.