August 5, 2010

Cancer initiative takes therapy to personal level

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Jeffrey Sosman, M.D., left, William Pao, M.D., Ph.D., and Cindy Vnencak-Jones, Ph.D., are leading Vanderbilt-Ingram Cancer Center’s new Personalized Cancer Medicine Initiative. (photo by Mary Donaldson)

Cancer initiative takes therapy to personal level

Vanderbilt-Ingram Cancer Center (VICC) has launched its new Personalized Cancer Medicine Initiative, becoming the first cancer center in the Southeast and one of the first in the nation to offer cancer patients routine “genotyping” of their tumors at the DNA level.

This information will then be used to personalize treatment by matching the appropriate therapy to the genetic changes, or mutations, that are driving the cancer's growth.

The first tumor types to be tested are some forms of lung cancer and melanoma, a form of skin cancer. Both have been notoriously difficult to treat but new therapies that target specific genetic alterations in the tumors have shown promising results.

Vanderbilt is further leading the nation in personalizing medicine by leveraging its sophisticated Electronic Medical Record (EMR) to use the genotype information in point-of-care decision-making.

“The EMR for each patient is automatically updated to contain the latest genome-based treatment information, so that all healthcare providers at Vanderbilt caring for the patient are fully informed and guided by the latest decision support on these advanced therapies,” said Dan Masys, M.D., chair of the Department of Biomedical Informatics.

“We know that genetic differences in humans at the molecular level not only contribute to the disease process, but can also significantly impact an individual's ability to respond optimally to drug therapy,” said Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of Vanderbilt University School of Medicine.

“We are rapidly expanding our ability to precisely identify genetic differences between patients and make rational treatment decisions at the bedside. Through a unique and cohesive set of advances that combine innovations in healthcare informatics, genomics, and drug discovery, we are beginning to deliver on the promise of the Human Genome Project, with highly personalized therapy for our patients.”

Vanderbilt's Personalized Cancer Medicine Program is led by William Pao, M.D., Ph.D., Ingram Associate Professor of Cancer Research and an expert in lung cancer.

“Historically, treatment decisions have largely been based on what a patient's tumor looks like under the microscope,” Pao said. “Over the past decade, it has become clear that the genetic make-up of a patient's tumor can have a significant impact on the patient's response to targeted therapy. With this genetically informed cancer medicine approach, we should achieve better outcomes.”

The VICC program will examine more than 40 mutations in lung cancer and melanoma that are potentially relevant to existing and emerging targeted therapies. As additional important tumor-specific mutations are identified, they will be added to the screening panel. New screening panels for cancers are in development.

“The Personalized Cancer Medicine Initiative is our commitment to providing the most cutting-edge treatment for our patients,” said Jennifer Pietenpol, Ph.D., director of Vanderbilt-Ingram and B.F. Byrd Professor of Oncology.

Jeffrey Sosman, M.D., professor of Medicine, noted that having the genotype information is also important to help patients avoid the side effects of traditional chemotherapy.

“We are starting to understand how each patient's tumor may have specific mutations that cause the cancer, but some of those mutations may also make the cancer vulnerable to specific therapy,” said Sosman, who directs the center's Melanoma Program. “Tumor genotyping allows us to personalize our approach. If a tumor is likely to respond to a targeted therapy then we can avoid the side effects of traditional chemotherapy.”