A new initiative to develop ‘personalised cancer treatment’ has today been launched. The experimental project has been designed to develop a screening program to test tumours for key genetic changes...
A new initiative to develop ‘personalised cancer treatment’ has today been launched. The experimental project has been designed to develop a screening program to test tumours for key genetic changes. It is hoped that in the future the results of such tests would influence treatment programmes, helping doctors choose the best drug for each person.
The new initiative, called the Stratified Medicine Programme, is being led by Cancer Research UK, the UK Technology Strategy Board and the pharmaceutical companies AstraZeneca and Pfizer. It is hoped that the work will lay the foundations for genetic testing of both patients and tumours to become standard practice, allowing the use of specialised drugs that target specific genes and mutations that can cause or influence the development of cancer.
In addition to laying the foundations for a genetic testing service, the information collected during the programme may be useful for research into new treatments; for example, by identifying new targets and by seeing how genetics affect people’s responses to various cancer drugs. Although people taking part in the early stages of this programme are unlikely to directly benefit, it is hoped that in the long-term, patients will be provided with individually tailored treatments that ultimately prove more effective.
What is the project looking at?
The project will initially look at mutations in breast, bowel, lung, prostate as well as ovarian cancer and melanoma. These cancers were chosen due to how common they are and because of the range of drugs available and in development that might potentially be used to treat them.
The project aims to collect samples from 9,000 patients treated at seven Experimental Cancer Medicine Centres around England, Wales and Scotland. This small-scale project will develop the best way of running a genetic testing service, which could then potentially be rolled out over the whole NHS.
How might this help fight cancer?
Although the process is still at an early exploratory phase, in the long term it is hoped that the programme will allow patients to be treated according to the specific genetic faults in their tumour.
As new drugs targeting cancers with specific mutations become available, they could be prescribed based on the genetic faults in the tumour and a person’s genetics, and potentially produce improved results. It might also reduce ineffective treatment, where the cancer does not respond.
Understanding how certain genes control cancer and determining how the disease evades treatment is another aim of cancer research. The genetic information collected will also provide a unique source of information to help guide future projects and drug development.
Cancer Research UK is currently involved in a number of other genetics-based research projects that might shed light on topics such as what makes certain people genetically susceptible to cancer, what genes and mutations cause cancer to progress aggressively once it does develop and how genetics govern the way some people respond to treatment.
How will the project work?
The first-phase of the project involves seven clinical centres and three genetic technology centres. Blood and tumour samples will be collected from patients treated at Experimental Cancer Medicine Centres to gather sources of both normal DNA and tumour DNA. The DNA sequences will then be examined to see if certain mutations are present in the tumour. The results will be linked to patient records, and anonymously placed in a central database to guide future research.
During this phase of the programme, the results will not influence treatment. However, they may show that a patient is eligible to participate in a clinical trial of one of the new targeted therapies, although this is likely to affect only a small number of patients.
Does the NHS presently examine genetics in cancer patients?
As some existing drugs are designed to treat cancers with certain mutations, genetic testing for single mutations is carried out in the treatment of some cancers. For example, the drug trastuzumab (Herceptin) is designed to treat breast cancers with high levels of the Her2 protein on the surface, which can be identified through genetic testing.
However, genetic testing of tumours to test for multiple genetic defects is not yet available on the NHS. At the moment there is no centralised way of testing samples, and therefore it is often done on a few samples at a time rather than on a large scale.
The aim of this programme is to develop a nationwide service, reducing variations and making results more comparable across the country.