Cancer Disparities

I learned a lot at the AACR Cancer Disparities Conference I attended in Miami. With all socioeconomic factors being the same, cancers are different in some ethnic groups. Black women are more likely to be diagnosed with breast cancer at an earlier age, and are more likely to have the triple negative pathology, which has a worse outcome. Hispanic children with an American Indian ancestry are less likely to respond to treatment for one of the leukemias.  All things are not equal.

Much about genomics was presented (which was great as I am involved in graduate genomic education!). A person can be genetically tested for ancestry, and many who identify themselves with a specific ethnic group are found genetically to have very mixed ancestry; for example the genetic ancestry for those who claim to be African American is very different for those in the US compared to those in Europe.

What was really interesting to me was that researchers said in the future cancer won't be seen as organ specific (breast, colon, pancreas) but will be identified by its genetic makeup. Two people with different cancers can have the same genetic mutation causing their cancer, so chemotherapy for a lung cancer might work well on someone with breast cancer or melanoma who has the same genetic mutation. All cancers are genetic....only 5-10% of cancers result from the genes we inherit from our parents, the rest result from mutations in genes we acquire as we live. Mutated genes can produce proteins that cause cells to become cancerous. Now that specific mutated genes are being identified, "targeted" therapies are being developed. A physician showed us an x-ray of a patient with lung cancer; there were many lung tumors visible. That patient had a rare mutation that responds well to a particular chemotherapy that is taken in pill form. He showed us an x-ray taken after the patient had taken one pill a day for a week....the tumors were gone. That is an example of a targeted therapy. Not all lung cancer patients will respond to that drug, only those with that specific mutation. Using genomics, they are beginning to be able to identify which drugs will work on which cancers and which patients will or won't respond to therapy. Some appendix cancer patients are now being tested for the KRAS mutation. If your cancer has this mutation, the drug Erbitux will have no effect on the cancer. It is a very expensive drug, so identifying this mutation saves the patient the cost and side effects of what would be a useless therapy.


There was also a lot of presented about clinical trials.  There are so many new cancer treatments and targeted therapies that need to be tested so that they can be approved by the FDA for use, but very few cancer patients participate in clinical trials.  I hope to learn more about clinical trials and to present the information here.