Cancer is a genetic disease caused by changes in DNA that control how cells function, especially how they grow and divide. These changes can be inherited but mostly arise randomly during life, as errors occur during cell division or from exposure to external carcinogens that damage DNA.
Precision oncology: knowing the genetic mutations in cancer and selecting therapies with the best response
Precision oncology is based on the search for tumor genetic alterations that may be predictive of response to an approved treatment or one in the experimental phase. The cancer that occurs in each person has specific mutations. Knowledge of these mutations can help to determine a personalized treatment, selecting therapies with a greater probability of response.
This would be a type of personalized oncology that goes beyond genetic testing of the tumor. It is a type of oncology that makes more sense and is more efficient if it is integrated into the therapeutic and evolutionary context of each patient. The aim is, therefore, to make a personalized therapeutic recommendation with the highest probability of success, taking into account the patient’s oncologic history and other factors that may have an influence.
Who is eligible for precision oncology?
If the patient has been diagnosed with a stage IV metastatic cancer, he/she can consult a specialist in Medical Oncology at Initia Oncology. At that time the case will be evaluated in a multidisciplinary committee to determine if it can benefit from a genomic test and what it will be. For this purpose, a report of the oncologic history, including copies of the X-ray evaluations, and of the anatomic pathology reports, must be provided. If a genomic test is indicated, a biopsy of the metastatic disease must be provided or a blood sample must be obtained. The samples will be analyzed in the laboratory and the results will be obtained within one to two weeks.
The process to be followed by the multidisciplinary oncology team will be as shown in the following image from Initia Oncology:
What results does precision oncology offer?
The result of the genomic test or examination will be evaluated by the multidisciplinary committee. Subsequently, the patient will receive a report with the genomic alterations that have been detected in the tumor and which targeted therapies or clinical trials will be the most appropriate, based on the scientific evidence and the patient’s particular situation. In this sense, tumor sequencing can lead to various therapeutic options:
- Standard treatment options
- Immunotherapy options
- Targeted therapy options
- Clinical trial options
- Off-label/compassionate-use therapy options