In cancer treatment, precision medicine, also called personalised medicine, uses detailed information such as genetic markers to guide targeted cancer therapy. In this article, we’ll explore whether it could unlock new treatment options for you.
What Is Precision Cancer Medicine?
Precision medicine is part of a major shift in how we approach medical treatment and cancer medicine is no different. And, unlike traditional methods, which use a broad strategy, precision medicine uses information to tailor treatment to the unique genetic makeup of a person’s cancer.
Imagine cancer as a locked door. Traditional cancer treatments can be like using a one-size-fits-all all key and it may not be able to open it. Precision medicine is akin to a lock-picking set with special tools designed for specific locks.
How Does Precision Medicine Work?
Precision medicine, or personalised medicine approach uses techniques such as genomic, molecular profiling and biomarker testing to match the tumour with potentially more effective cancer drugs and treatments.
Key components of personalised medicine
Precision medicine relies on several key components to deliver targeted therapy. These components help tailor treatment to each patient’s unique genetic profile, ensuring more effective and personalised care.
Genomic Medicine
The study of a patient’s genes and their functions. Understanding genetic mutations can help in predicting how cancer will behave and which treatments will be most effective.
Biomarkers
These are biological molecules found in blood, other body fluids, or tissues. They are a sign of a normal or abnormal process, or a condition or disease. In cancer treatment, biomarkers can help with disease detection and determine the most effective approach.
Molecular profile
This involves analysing the genetic and molecular characteristics of the tumour to identify unique patterns that can be targeted with specific therapies
Precision Medicine for Rare Cancer Patients.
Whether it’s a rare cancer or more common forms, such as bowel cancer, a cancer diagnosis is a challenging time. But rare cancer followers face many specific challenges and finding the right treatment is one of them.
The challenges of treating rare cancers
Rare cancers are cancers that affect fewer than 6 out of 100,000 people every year. As a percentage, that’s less than 0.006% of people. This leads to delayed diagnosis and treatment as there is relatively little information to help patients and doctors make treatment decisions.
Collectively, rare cancers account for about 24% of all cancers diagnosed in the UK and Europe. This means that while each rare cancer type individually affects a small percentage of people, the collective impact of rare cancers is significant, affecting a large portion of the population.
Precision medicine can be used to identify characteristics of a tumour that help to make a diagnosis, predict how it will respond to treatment and find targets for existing drugs that are available and approved for other cancer types.
In some cases, precision medicine offers patients opportunities for off-label drugs or research trials with experimental drugs.
What are the benefits of precision cancer medicine?
Cancer cells have changes (mutations) that make them different from normal cells. Every form of cancer has its own genetic makeup and genomic testing gives us information about DNA, genes, proteins and molecular features of cancer. This tells us how a cancer grows, divides and spreads. Precision medicine aims to target those differences.
Enhanced Cancer Diagnosis
Individualized medicine can transform cancer diagnosis by helping doctors to classify tumours more accurately. Cancer has traditionally been diagnosed by looking at the tissue where it started and its appearance under a microscope, such as identifying adenocarcinoma in the lung.
This new approach helps us to find different biomarkers, genetic changes and molecules that give us a more accurate diagnosis and help guide targeted treatment
Targeted treatment options
Precision medicine enables the development of personalised health care plans based on the unique genetic makeup of a patient’s cancer. This approach may increase the effectiveness of treatments and reduce unnecessary side effects.
Prognosis and prediction
Additionally, precision medicine can provide information on prognosis by identifying specific genetic mutations and molecular characteristics of the cancer, which can help predict the likely course of the disease and response to treatment.
Targeted therapy with fewer side effects
Targeted therapies specifically combat characteristics of cancer cells that differ from normal cells. This makes them less toxic for patients compared to treatments like chemotherapy and radiation, which can also harm normal cells.
Access to new drugs or clinical trials
Further, precision medicine can offer patients access to new treatments, off-label drugs and drug trials tailored to their specific genetic profile. This offers new treatment options when others have been exhausted, giving hope, time and a chance to let their participation in a trial help others like them.
Precision Medicine for Brain Cancer Patients
Brain cancer is a relatively rare form of cancer, accounting for around 1.5% of cancer cases in the UK. Treating brain tumours surgically is challenging, and to reach cancer cells, chemotherapy must pass through the blood-brain barrier, often limiting its effectiveness.
Given the complexities and rarity of brain cancer, precision medicine offers new hope. Let’s explore how this innovative approach can guide therapy for brain cancer patients.
Genomic testing in brain cancer
Genomic testing in gliomas, the most common type of brain cancer, can identify mutations in the IDH gene, which plays a significant role in tumour progression.
Identifying IDH mutation status can help predict tumour behaviour and tailor treatment plans, offering better prognostic and therapeutic guidance for patients
Furthermore, recent research has also found that Vorasidenib, which blocks the activity of mutant IDH proteins, increased survival in some glioma patients.
Molecular targets in brain cancer
Molecular profiling of the MGMT gene in glioblastoma can help guide prognosis and guide treatment. The MGMT gene makes an enzyme involved in DNA repair. Patients with a tumour with a silenced (methylated) MGMT gene have a reduced ability to repair DNA damage caused by chemotherapy drugs. This means that these patients may be more likely to benefit from the alkylating agent temozolomide.
Current guidelines recommend assessing MGMT status in all newly diagnosed glioblastoma patients to guide therapy decisions.
mRNA Vaccines for brain cancer patients
mRNA vaccines represent a promising approach to treatment, including brain cancer. These vaccines hold the potential to activate the immune system to target cancer cells. Scientists hope that mRNA vaccines can be customized to each patient by identifying unique tumour proteins through genomic sequencing, creating a personalised vaccine.
Notably, a clinical trial involving four glioblastoma patients aimed to test the feasibility and efficacy of mRNA vaccines. However, while the trial wasn’t designed to show if the tumour could be treated with the vaccine, the results were positive, with all participants showing a strong immune response, indicating the potential for these vaccines to target tumours effectively.
Does precision medicine work?
Yes, and there are several examples of it working in current patient care. A good example is how genomic research has helped in the diagnosis, classification and treatment of breast cancer.
Breast cancer can be classified into distinct groups depending on the presence of different proteins. One such protein is called HER2 (human epidermal growth factor 2) which drives the growth of breast cancer cells.
Breast cancer patients who are positive for HER2 can be treated with a drug called Herceptin, which targets the HER2 receptor and slows or stops the growth of the tumour.
We are all unique, and a diagnosis of cancer only underlines that fact. Personalised medicine shows us a future where cancer treatment can be as unique as we are. The promise lies in its ability to provide targeted, effective, and less toxic treatment options, especially for those with a rare or challenging diagnosis.
Using genetic testing, precision medicine matches treatment to the unique characteristics of a person’s cancer, improving diagnosis and treatment. It opens the door to new therapies and pharmaceutical clinical trials that can enhance the quality and length of life for cancer patients and their families.
If you or someone you care about has been recently diagnosed with a rare cancer and you have any questions, feel free to contact us here. We’re here to help you find the answers and support you need.
References
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- Demeure M. J. (2019). The Role of Precision Medicine in the Diagnosis and Treatment of Patients with Rare Cancers. Cancer treatment and research, 178, 81–108. https://doi.org/10.1007/978-3-030-16391-4_3
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Remy is a dedicated physician and medical writer. With over a decade of clinical experience, he has worked globally – from clinics in South Africa and Brazil to research collaborations with universities in London and Cape Town. Remy completed his Medical training at University College London.
A seasoned medical writer and published researcher, Remy’s work has appeared in prestigious journals such as Nature and magazines like Woman & Home. He has collaborated with the Bill and Melinda Gates Foundation the World Organization of Family Doctors (WONCA) and Johnson & Johnson.
Remy’s mission at Gena Health is a personal one. He was inspired to join Gena by his cousin’s battle with neuroblastoma, a rare cancer she fought bravely before passing away at just 16. He is committed to educating people on issues related to rare or hard-to-treat cancers, and making the world a kinder and more hopeful for patients and their families facing similar challenges.
