Next Generation Sequencing Leads to New Options When Standard Treatments Fail

No longer the new player on the team, next-generation sequencing (NGS) is well established as having an influence in clinical care. In recent years, NGS has been responsible for many noteworthy discoveries.

According to a recent article in Newswise, researchers at the Rogel Cancer Center of Michigan University conducted a study of over one thousand patients. Genomic alterations (changes in genes) were discovered in almost eighty percent of these patients. Alterations in genes are responsible for changing the function of a gene which may cause or spread cancer.

NGS has made it possible to analyze (profile) a person’s DNA characteristics resulting in improved cancer therapy. It has been especially effective for patients with cancers of unknown origin.

When conventional cancer treatments have failed or doctors are unable to determine where the cancer originated, NGS is usually able to identify the tumor’s mutation. This enables the physicians to determine which medicines would target the newly discovered mutation.

About the Rogel Study

The results of the Rogel Study were published in a recent issue of JAMA Oncology. Of 130 patients receiving sequencing-directed treatment, almost forty percent received some type of clinical benefit through the identification of ‘actionable’ genomic mutations (alterations).

Note that when a mutation in a sample tumor is identified as potentially ‘actionable’, it is an indication of a DNA change with predicted treatment response.

Further, twenty percent of patients in the study had their disease kept under control for a minimum of one year.

For patients with cancers not otherwise specified, NGS decoded tissues of origin in fifty percent of all cases. This new information led doctors to administer the appropriate standard and targeted therapies.

About Inheritable Risks

One of the most impressive results of the Rogel study was the identification of the inheritable risks of cancer in sixteen percent of patients. Dr. Erin Cobain, Michigan Medicine oncologist and one of the principal study authors, commented that family members with inherited mutations may have an increased risk of cancer.

Therefore, Dr. Cobain states that counseling and genetic testing in families are important. It also suggests the widespread effect of NGS not only in patients but in their families.

Investigators in the Rogel study reviewed approximately seven years of data provided by 1,015 patients who took part in a Michigan sequencing program (Mi-ONCOSEQ) from 2011 through 2018. More than 3,500 patients to date have participated in tumor sequencing.

About NGS

Dr. Cobain’s description of NGS is that the test looks for changes in the RNA and DNA of a tumor. The changes that occur in the RNA and DNA do not occur anywhere else in the cells. Dr. Cobain explains that because the recommended medications target abnormal cells it will lessen the impact on healthy cells.

Dr. Cobain also points out that the Michigan University’s tumor board meets regularly to review some of the more complicated findings. The Board consists of scientists and doctors who have conducted the screenings and who then analyze the more intricate results.

The doctor further explained that her team identified patients who had advanced cancer but at the time did not have therapeutic options. After testing, the doctors kept the cancer under control for over a year.

Dr. Cobain’s team also found answers for patients who had cancer of unknown origin. Upon testing, they identified mutations in sixteen percent of these patients. By going a step further and providing genetic testing for their families, the doctors will be able to help the patients’ families lower their risk of cancer.

The authors of the Study expressed their belief that their precision medicine approach is especially productive in cancers with no standard-of-care options.

The study received grants from the NIH, the NCI, and the Prostate Cancer Foundation.

Rose Duesterwald

Rose Duesterwald

Rose became acquainted with Patient Worthy after her husband was diagnosed with Acute Myeloid Leukemia four years ago. He was treated with a methylating agent While he was being treated with a hypomethylating agent, Rose researched investigational drugs being developed to treat relapsed/refractory AML.

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