Where We Are Today in Understanding Cancer

Bill Nelson - The Future of Personalized Cancer Medicine

Learn more about ‘Personalized Medicine’ by watching Dr. William Nelson from the Sidney Kimmel Comprehensive Cancer Center located at the Johns Hopkins Medical Campus

Cancer is a set of complex diseases. The origins of cancer typically begin with a break in the DNA (mutations) within our cells. The DNA mutations, result in erroneous signaling messages to the cells causing uncontrolled or unregulated cell growth. New research on tumors using next generation DNA sequencing technology seems to indicate each person’s cancer is genetically unique. The treatment implications from these findings are profound since it suggests therapy should be tailored to the individual patient. This paradigm is commonly referred to as ‘Personalized Medicine’ but is also called ‘Precision Medicine’.

Cancer Metastasis

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Cancer metastasis, beyond the primary tumor, is a killer. Greater than 90% of the deaths related to cancer, are due to the metastatic processes within cancer.

Learn more about cancer metastasis from a short article provided by:

Charles (Karl) Saxe, PhD
Director, Cancer Cell Biology and Metastasis Program, American Cancer Society

Read more

The central theme of The Breakthrough is to bring focus on cancer stem cells (CSCs) and how they may play a pivotal role in metastasis. By providing a better faster and more inexpensive method to isolate and capture CSCs, medical researchers can devote more time to the study of how CSCs are genetically different and what targeted therapies may be useful to stop their spread.

Typical Chemotherapy Response Rates Are Surprisingly Low

Typical chemotherapy response rates for cancer patients are surprisingly low, ranging from 5-55% as illustrated by the data from the Medical College of Wisconsin.

 

Response

Rate

Median Duration of

Response

Median Survival
Breast 25-55% 6-12 months 24-36 months
Colon 25-35% 6-8 months 12-18 months
Esophagus 30-50% 4-6 months 6-9 months
Lung (Non-Small Cell) 20-30% 4-6 months 6-9 months
Stomach 20-50% 4-6 months 6-12 months
Melanoma 15-25% 4-6 months 6-9 months
Pancreas 10-25% 3-5 months 6-9 months
Liver (Hepatocellular) 5-15% 2-4 months 6-9 months
Biliary (Cholangio) 15-25% 2-4 months 6-9 months

Medical College of Wisconsin #099 Chemotherapy: Response and Survival Data, 2nd ed Author(s): David E Weissman MD and Charles F von Gunten MD, April 2009.

"This information is not representative of all cancer patients. The data represent the ‘best case’ outcome, from a population of patients who were in good enough health to participate in a clinical trial (e.g. ambulatory, good functional status). Actual responses and response durations for a non-clinical trial population will likely be poorer."

David E Weissman MD and Charles F von Gunten MD Chemotherapy: Response and Survival Data, 2nd ed

Important information to retain from the chart is that different types of cancer will respond differently to treatment. While how many patients respond, the response duration and time of survival may vary, the data shows much improvement is needed in the treatment of cancer.

Therapy Options Are Frequently Based On Anatomical Location

Therapy options are frequently based on anatomical location, not on tumor genetic sequence analysis.

The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 23 of the world's leading cancer centers devoted to patient care, research, and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care.  NCCN updates and publishes clinical practice guidelines, describing recommended treatment protocols appropriate for use by patients, clinicians, and other health care decision-makers.

Current NCCN guidelines frequently classify cancers based on the anatomical site where the primary tumor has been identified. Any changes to the NCCN guidelines typically require extensive clinical evidence demonstrating significant improvement in patient outcomes. Unfortunately generating this level of evidence typically requires years and large amounts of research funding.

New "Targeted Therapy"

Newly developed “Targeted Therapy” pharmaceuticals are the new Smart Bombs against cancer cells that can stop the mutated signaling pathway defects.

Understanding the targeted therapy Herceptin®: A Story Of Discovery

Another example of targeted cancer therapy are the new checkpoint inhibitors.

What is HER2?

What happens to HER2 in Breast Cancer?

Inhibiting HER2