Cancer Genomics

I am back in school! I am working on a graduate Oncology Certificate through Loyola University in Chicago. I love going to school, and I love learning, so I'm excited!

I am only taking one class right now, Cancer Genomics. Not many oncology certificate programs offer classes in cancer genomics, it's one of the reasons I decided to pursue the program at Loyola. I've been exposed to much research in cancer genomics attending AACR research conferences, so have a little bit of knowledge. I know cancer genomics will change the future of cancer care.

Cancer genomics is about the genetics of cancer. Cancer is a genetic disease; it is caused by altered genes. Genes that normally control and limit the growth of cells goes awry. Only a small percentage of cancers are caused by genes inherited from our parents, only 5-10% of cancers are inherited. Most cancers are caused by genetic defects/changes that occur over our lifetimes. Recent studies have found that cancers do not arise from a single defective gene, but from a group, or series of genetic defects.

It was also discovered that even in people with the same cancer, say colon or ovarian cancer, the genetic defects in the tumors from two patients with the same cancer can be very different. So even two of us with signet ring appendix cancer may have very different tumors that respond differently to treatment. This may explain why chemotherapy for one patient’s colon cancer is not effective on another patient's colon cancer (or appendix or ovarian cancer).

That may sound like bad news, but it may in fact be good news. A new field is rising from cancer genomics, pharmacogenetics. It is possible that all of our individual tumors will be genetically analyzed in the future. It's possible that based on the genetic findings of our tumors, they will be able to determine which chemotherapy will be most effective for a particular patient's cancer. That means no one would have to suffer the side effects and expense of going through a chemotherapy regime that would not benefit them.

At the presentation, they said it will one day also be possible based on a patient's genetics to determine who will have severe reactions and side effects to a particular chemo, so that they can avoid using the particular chemotherapy for that patient.

It was interesting; one of the presentations I attended spoke of a particular chemotherapy in a clinical trial. The chemotherapy only helped 10% of the patients in the trial, so the drug was not approved by the FDA. The interesting thing was that the 10% who did respond had an overwhelmingly positive response, many went into remission. It could be that particular 10% had common genetic defects, and that the particular chemo was effective for that group. It could be in the future that treatments are tailor made for the genetics of our particular tumor.

Will let you know more when I know more...but it's a brave new world in cancer care!