Although 2013 has hardly seen a shortage in cancer-related research breakthroughs, chances are you haven’t heard about any of them. The bulk of oncological inquiry unfolds in a highly specialized realm, and laymen without titles and letters must often content themselves with sensational headlines and tenuous paraphrase. Still, critical developments occur almost daily; and in a world where cancer kills upwards of 7 million people each year, it may be in our best interest to keep up.
To find out what’s going on, we spoke to Dr. Sandeep Reddy, medical oncologist and chief of staff at Los Alamitos Medical Center. Our discussion focused on three critical developments: the National Institutes of Health’s (NIH) Cancer Genome Atlas Project; the global effort to personalize tumor therapy; and the gradual emergence of cutting-edge technology in oncological diagnosis and treatment.
MD: For the past decade, NIH researchers have been cataloguing genetic mutations associated with many different cancers. Recent advancements suggest that the same mutations occur across a wide variety of tumors. Given enough time and funding, do you think it would be possible to compile a list of all genetic errors associated with major cancers? If so, could a single test ever screen for all types of the disease?
SR: It’s certainly possible that a comprehensive list of genetic errors associated with major cancers could be compiled; however, I believe this is highly unlikely to happen any time soon. Of course, not all errors are genetic, as some cancers may be the result of epigenetic abnormalities. A reliance on sequencing alone may leave us open to missing these important potential causes of disease.
In terms of whether a single test could screen for all types of cancer, it’s also possible. But until that time comes, utilizing a combination of molecular diagnostic technologies, especially when determining a treatment path forward for cancer patients, is the most clinically appropriate option.
MD: Many recent studies refer to cutting-edge analytical toolkits and hi-tech instruments. Have simultaneous developments in technology helped oncologists come up with more sophisticated diagnostics and screening protocols?
SR: Without question, the technological advancements we’ve seen in the past ten years have completely transformed how oncology is practiced. Prior to that, very few cutting-edge diagnostic and analytical tools were even available for oncologists to use. This is especially evident in cancer types like breast and lung cancers, where a patient will almost certainly undergo some type of genomic test, and likely more than one, to determine the expression levels of certain key genes in their tumor. These analyses are a critically important part of the treatment determination process, as they help indicate to an oncologist which drugs may be effective or ineffective. Using these innovative tools is not only good clinical practice, often leading to better patient outcomes, but also more cost-efficient, as the expense of the screening or testing is generally much less expensive than the cost of ineffective treatment.
MD: Scholarly journals frequently talk about “personalized” care and treatment for cancer patients. Is such profiling the future of cancer research?
SR: Personalized care isn’t the future of cancer research and care – it’s the present. Pick up any respected medical journal or attend any major oncology meeting, here or abroad, and you can see how the pursuit of individualized care dominates the research landscape. If you’re a cancer researcher seeking to publish data on a potential new drug, your study will likely include some component of genetic and/or genomic analysis. Cancer patients themselves are helping to drive the personalized medicine discussion in a much more significant way than in the past. Many patients have now become vocal advocates for their own care and are demanding more individualized treatment planning.
Sandeep Reddy is a clinical assistant professor of medicine at the Geffen/UCLA School of Medicine and a practicing oncologist at Los Alamitos Hematology and Oncology. You can read about some of his publications here. To learn more about personalized care, technological advancements, and the Cancer Genome Atlas project, visit the National Cancer Institute’s website.