September 14, 2017

Q and A: How has genomics led to precision cancer care?

By Sharon Rosen

Aleksandar Sekulic, M.D., Ph.D.

How has cancer care changed with advances in genomic medicine? For example, for patients diagnosed with melanoma today, will their treatment options be different than those that were available 10 or 15 years ago?

These are some of the questions we posed to  Aleksandar Sekulic, M.D., Ph.D., associate director, Mayo Clinic Center for Individualized Medicine, who now has a new role as deputy director, Mayo Clinic Cancer Center, in Arizona. Dr. Sekulic explains how genomics has already advanced cancer care, and how it will continue to impact cancer screening and treatment in the future.

Question: What did the Human Genome Project, which mapped the first human genome, tell us about how our genes impact our health and diseases like cancer?

Dr. Sekulic: The Human Genome Project revealed important insights into how our genetic code controls mechanisms that affect health and disease. We now know that cancers are caused by abnormalities occurring in our genes and this changed the way we approach cancer. For example, fifteen years ago, we largely viewed melanoma as a single disease. Now we know melanoma is a group of diseases, each with a different set of genes driving the cancer. Today, we’re using this knowledge to develop individualized diagnostic tests and targeted treatments for patients.

Q: How has cancer care improved with use of genetic and genomic testing?

Dr. Sekulic: There are many current and emerging advances in cancer care, including:

  • Identifying inherited genetic changes linked to cancer risk: We have identified many genetic mutations linked to an increased risk for developing certain cancers. For example, BRCA1 and BRCA2, are linked to a higher risk for breast and ovarian cancer.
  • Developing targeted therapies: By identifying how a genetic mutation is causing cancer growth, we can work to find targeted treatments aimed at “turning off” that process and stopping cancer growth or killing cancer cells.
  • Tracking cancer with a blood test: Recently, significant advances have occurred indicating that cancer cells shed DNA into the bloodstream. If this research is broadly validated, this raises the possibility of using these blood tests for detecting cancer, monitoring therapy and identifying cancer recurrence in ways that complement or even replace some of the imaging tests that we currently use. In fact several such blood DNA tests are already being used in the clinical setting.

Q: Why is pharmacogenomics testing important in choosing the right cancer treatment?

Broadly, pharmacogenomics assesses the way a person’s genes affect how they process medications, and as such it can play a critical role in selecting the right treatment and dose for patients, including cancer patients. At Mayo, we can currently test for sensitivity to more than 400 medications with a blood-based pharmacogenomics test. This is important because many cancer patients are placed on more than one medication at a time. These test results can be helpful in selecting the right drugs and dosages, maximizing the benefit of the therapy and reducing the chance for any harmful side effects.

Q: What’s on the horizon for new developments in cancer care?

Dr. Sekulic: There are many opportunities to improve care as our knowledge grows. Some of these areas include:

  • Better prevention, screening and treatment: Imagine a blood test that could detect a genetic mutation that increases your risk for cancer? As we discover more individualized genes linked to cancer risk, we are also developing diagnostic tests that will improve cancer prevention through earlier screening, detection and treatment, reducing the overall burden of cancer.
  • Better understanding of genetic factors leading to cancer risk in minority and underserved populations: Many minority and ethnic groups are not adequately represented in precision medicine research. As we address this disparity, we will get a greater understanding of what genetic factors increase cancer risk in different populations. This will help us tailor cancer diagnostic tests and treatments on an individual basis and on a population level.

Register for the 2017 Individualizing Medicine Conference

Learn more about precision medicine and how that can be applied to improve diagnosis and treatment for many conditions at Individualizing Medicine 2017: Advancing Care Through Genomics.

The Mayo Clinic Center for Individualized Medicine, is hosting the sixth annual genomics conference, October 9–10, in Rochester, Minnesota.

Mayo Clinic Center for Individualized Medicine is hosting the conference with support from the Jackson Family Foundation.





Tags: #cancer treatment, #Genomic analysis, #pharmacogenomics testing, #targeted therapies, cancer, center for individualized medicine, Dr. Aleksandar Sekulic, Genetic Testing, genomics, mayo clinic, medical research, Melanoma, Precision Medicine

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