What is precision medicine?
Cancer is a unique disease. Even in people with the same cancer, each patient’s cancer is different depending on the genetics changes present in its cells. This variability between patients could explain why certain patients respond to treatment and some do not.
Currently doctors decide on patients’ treatment based on the type of cancer, where it is in the body, if it has spread, the size of the cancer and what the cancer cells look like. Though this approach works for many people, it does not work for all.
Precision medicine uses genetic screening to identify the genetic changes present in each patient’s cancer. Based on these results, patients receive a treatment that is tailored to their specific cancer genetic profile. By giving patients the right treatments, targeted to their cancer, at the right time, we avoid unwanted side-effects and ineffective medication and ensure better survival.
In the longer term, it will also help researchers and doctors to develop therapies that target specific genetic changes and allow them to design better clinical trials for future patients.
The National Health Service as a whole will benefit as more effective treatments will save time and reduce costs.
Simply contact us and one of our team will get in touch to discuss how we can help.
What is a genome?
Your genome provides all the instructions your body needs to grow, develop and stay healthy. An identical copy of these instructions can be found in every one of the millions of cells that make up our bodies.
A genome is formed when four different chemicals pair together repeatedly to form a long strand of DNA. Because the names of these chemicals are often shorted to simply A, T, C and G, scientists often talk about “letters” in a genome.
The human genome has around three billion letters in it.
It is important to realise there are more than three million individual differences between the letters in one person’s genome sequence and anyone else’s. These differences are what give us different coloured eyes, hair or blood type for example.
Importantly, we also know that the DNA sequence within the cancer cells of one pancreatic cancer patient will be different to the DNA sequence within the cells of any other pancreatic cancer patient.
What happens if my genome is damaged?
Throughout your lifetime, your body will copy your genome many, many times over. It does this to keep you healthy by making sure that your cells grow, die and are replaced in an organised way.
However, sometimes during this copying process, the sequence of letters can mistakenly become mixed up or altered. In most cases such changes, called “mutations”, are corrected by the body and so have little affect on a persons health.
However, a genetic disease, like cancer, can happen if the DNA sequence become corrupted in a way interferes with the body’s ability to follow the original instructions.
Types of genomic damage – DNA damage
Previous work from our lab has shown that around a fifth of patients with Pancreatic Cancer have changes in the genetics of their tumour that “disable” the tumour’s ability to repair damage to its own DNA.
This leaves a genetic scar in the tumour that we can detect with new gene sequencing technologies. We believe that these tumours will be more susceptible to treatments that causes further DNA damage (for example Platinum chemotherapy such as FOLFIRINOX or FOLFOX-A). These treatments lead to extensive DNA damage since the tumour is unable to repair the damage caused by these treatments. This in turn will cause the cancer cells to die off as the levels of DNA damage exceeds what the cell can cope with to survive.
We hope to use this ‘genetic scar’ as a marker that predicts which patients respond to these treatments and this will be tested in clinical trials such as PRIMUS-001 and PRIMUS-002.
Precision medicine – Right drugs, right patient, right time
Understanding the human genome enables doctors to more precisely deliver the right drugs to the right patients at the right time. This is precision medicine.
Currently a cancer patient’s treatment is based on the type of cancer, where it is in the body, the size of the cancer, what the cancer cells look like under the microscope and if it has spread. Though this approach works for many people, it does not work for everyone. Precision medicine is an approach to disease diagnosis and treatment that takes into account the differences in individual cancers.
Genes are found in every cell in our body, including cancer cells, and contain the instructions that control how our bodies function. Most cancers start due to changes in genes that happen over a person’s lifetime. Based on the different genes that change in the cancer cells, there will be different types of cancer. Pancreatic cancers can be very different from each other on a genetic level and this makes it hard to find a single treatment that will work for them all. It also explains why some people can have a fantastic response to treatment, and others will have little or no benefit.
Precision medicine uses genetic testing to identify the genetic changes present in each patient’s cancer. Based on these results, patients would receive a treatment that is tailored to their specific cancer genetic profile. In the future, by giving patients the right treatment, targeted to their cancer, at the right time, we avoid unwanted side-effects and ineffective medication, and ensure better survival.
‘Precision medicine holds hope for all cancer treatment’ said Professor Biankin, but especially for less common, high-mortality cancers, such as pancreatic cancer. ‘People with pancreatic cancer have poor outcomes because it can be difficult to diagnose due to vague symptoms, standard treatments are less effective than in other cancer types, and there is limited access to new treatments.’