Even patients who have identical diagnoses may look completely different at the molecular level. Because of this, researchers are striving to develop ways to identify small-scale differences in cancer cells that would allow doctors to treat patients according to the genetic basis of their cancer.
"We're able to get out of that biopsy material the DNA and the RNA, the nucleic materials, so that we can look at the genes and the proteins to see what is wrong with that tumor, compare it to other tumors, and see if these genes are telling us which chemotherapy or which targeted therapy to use," said Dr. Harvey Pass, a cancer researcher at NYU Langone Medical Center who is also on the advisory board of Rosetta Genomics.
"This is the model of personalized cancer therapy," says Dr. Marc Ladanyi, chief of the Molecular Diagnostics Service at Memorial Sloan-Kettering Cancer Center in New York. "We don't just look at [a tumor] under the microscope to see how aggressive it is; we also characterize which mutations are present in the cancer, so that from the get-go you know if your cancer can be treated with specific drugs."
At Sloan-Kettering, patients with non-small cell lung cancer -- the most common form of the disease -- have their cancer cells tested for over 40 different mutations. Once a mutation is identified, doctors can suggest specific treatments based on the patient's cancer mutation.
Clinical trials are underway at the M.D. Anderson center to determine the success rate of genetic tests, such as the ones performed at Memorial Sloan-Kettering, not only in lung cancer but in metastatic colorectal cancer as well.
Currently, the most widely accepted genetic test used to guide cancer treatment is that for HER2, a mutation present in 15-20 percent of breast cancer patients. The HER2 test is now a standard recommendation for newly diagnosed breast cancer patients, because women with the HER2 subtype are more receptive to certain breast cancer therapies.
Genetic testing on tumor specimens, however, can be plagued by inaccuracy. So researchers at Johns Hopkins University in Baltimore are trying to take genetic testing to a new level. Rather than taking a closer look at the cancer cells, Dr. Bert Vogelstein and his colleagues there have developed a method that uses genomic sequencing to create blood tests. These tests, the said, could be used to monitor tumor levels after treatment and determine cancer recurrence.
"Using this approach, we can develop biomarkers for potentially any cancer patient," says Dr. Victor Velculescu, co-director of the cancer biology program at Johns Hopkins.
Such is the hope of Wigbels, who is now trying to make the treatments that have helped him more accessible to everyone. Following his experience, he founded TakeAimAtCancer.org to raise money for genomic cancer research.
For more on Wigbels's story, visit TakeAimAtCancer.org.