Cancer Genomics: Targeting Treatment to the Patient

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Jeff Wigbels didn't smoke. He had no family history of cancer, and he was a triathlete and marathon runner. By many measures, he was a picture of health.

That was before October 11, 2006, when doctors discovered a baseball-sized tumor in his lung.

Wigbels, who is from Atlanta, had lung cancer, and further tests revealed that by the time it was detected, the malignant cells in his lung had metastasized to his chest, abdomen and brain. Facing a diagnosis of stage 4 lung cancer, Wigbels knew that the odds were heavily against his survival.

At the time, Wigbels's wife Tiffany was ready to give birth to the couple's second child. So Wigbels waited until a day after she delivered on Oct. 12 to tell her of his diagnosis -- and that he was unlikely to live long enough to see his child's first birthday.

"We held off telling Tiff until we had Jack," he said. "And the next day or two, right after that, I had to tell Tiff that quite frankly, there may not be an opportunity for me to be here to help raise our child, she may have to do that all by herself."

The initial treatment recommended to Wigbels was the standard regimen of radiation and chemotherapy. But after researching his options, Jeff met with Dr. Roy Herbst at the University of Texas M.D. Anderson Cancer Center. There, he enrolled in a clinical trial called BATTLE, designed to test the effectiveness of an individualized therapy based on tailoring treatments to the patient's genes.

Today he is alive, and he continues to defy the odds.

"The drugs were somewhat targeted for the most part to everything that was going on with me," Wigbels said. "It was not a random standard of care procedure."

Indeed, while all cancers are not equal, patients with cancer traditionally have been treated that way, with a standard treatment regimen built from chemotherapy, radiation and surgery.

But now promising breakthroughs in cancer research -- specifically in a field known as cancer genomics -- are giving doctors a new tool. Cancer genomics is a quest to understand what is wrong in that patient's genes and target treatment there. The patient's own genes are used to personalize treatment.

"The testing for the BATTLE trial helped determine which of four arms of the trial [Wigbels] would be assigned to," Herbst said, "and hence personalized his therapy."

Cancer Genomics: Targeting the Treatment to the Patient

Francis Collins, director of the National Institutes of Health, said the approach may prove to be a milestone in cancer treatment.

"It is the most exciting time in cancer research ever," Collins said. "Fifty years from now, people will look at how we treated cancer in 2010 and wonder how people went through that.

"My dream is that through cancer genomics we will discover in the coming years a long list of effective, targeted therapies that will take the place of what we do now for many patients and will lead to a circumstance where cancer is no longer such a feared diagnosis, but a chance to get a treatment that you know is going to work."

Cancer Genomics Researchers Seek Individualized Cancer Treatment

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.

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