Decoding Genes to Target Cancer

David Bartlett, MD

Malfunctioning genes spark the growth of cancer cells. And by uncovering patients’ DNA changes within those cells, experts can determine effective treatments for each patient and gain insight into their prognosis and therapy response.

This kind of highly personalized and precise medicine takes place at the new Center for Genetics and Precision Medicine at the AHN Cancer Institute.

The state-of-the-art facility offers a host of gene sequencing technologies to find cancer-related abnormalities. Researchers use the genomic information from tumor biopsies and blood samples to help physicians detect, treat, and manage cancer.

“We are implementing molecular testing for our patients, which will detect cancers, while retaining valuable patient samples and data within our health care system,” said William LaFramboise, PhD, AHN Cancer Institute professor and chief genomics technology officer. “This is making precision medicine a reality, using molecular profiling as a standard of care for many cancer types while customizing the treatment to fit each patient.”

AHN researchers capture and generate gene sequences from cancer cells in tumor biopsies. Their DNA is extracted, sequenced, cataloged, and studied for abnormalities that could cause tumor growth. Clinicians analyze these abnormalities to determine if they match known mutations that have previously responded to therapies, or if there is a potential treatment option not previously considered.

“As clinicians, we are driven to help our patients, so to have the ability to uncover more ways to stay ahead of this disease is always very exciting,” said David Bartlett, MD, system chair of the AHN Cancer Institute. “For instance, our researchers may be able to sequence a tumor’s DNA before and after a patient’s treatment, allowing them to learn how cancer adapts and possibly resists therapies.”

A Little DNA goes a Long Way

Advanced genomic testing was made possible by the 2003 Human Genome Project. Researchers mapped the entire human genetic code, discovering that each human cell is packed with around 21,000 genes, distinctively expressed in every cell. In the following years, thousands of cancers have been sequenced, creating a vast catalog of mutations and treatment outcomes.

Building on this foundation, the AHN Center for Genetics and Precision Medicine can tailor treatments to each patient, rather than rely on a one-size-fits-all approach to cancer care.

Dr. LaFramboise said the Molecular Tumor Board — comprised of cancer, molecular, and genetic experts — is integral to providing clinicians and patients with a personalized medicine perspective. They work together to review data and determine the most effective treatment plan for each patient,

including finding clinical trials matched to their disease’s characteristics.

AHN’s genomics efforts will also include a biorepository of genomic data from AHN patients who previously underwent molecular profiling by commercial vendors and agreed to share their information. These data, combined with new genomic results from the AHN Center for Genetics and Precision Medicine, provide a footprint of different cancers.

“This information can help identify family members at risk for the same genetic disease as well as help other patients throughout the region stricken with the same cancer,” Dr. LaFramboise said. “We feel very fortunate for the support of our patients as we grow this precision medicine at AHN.”