According to a story from Medscape, a recent large scale trial focused on cancer treatment has produced some interesting results. The trial was aimed at testing next generation sequencing of cancer tumor biopsies in order to see if the results could help determine which drug would be the most effective in treating an individual patient’s cancer. The study, which included a total of 5,954 cancer patients, focused primarily on variants of cancer that were considered underexplored, including rare cancers. 

Finding Treatment Options

The patients in the study had either seen their disease progress while using the standard therapy or had a rare cancer form that had no standard treatment. The goal of sequencing is to find genetic alterations in the cancer cells that could be targeted by currently available cancer therapies. The researchers found that 37.6 percent of these patients had genetic alterations that may respond to these medicines. 17.8 percent of patients were ultimately switched to one of these targeted therapies. 71.3 percent of tumors sampled had mutations that conferred resistance to cancer therapies; 11.9 percent of samples had multiple mutations that could be targeted.

Implications

Study chair Dr. Keith T. Flaherty said that these findings should mean that next generation targeted sequencing of tumors should become a standard component of the treatment process for patients with advanced cases of cancer. As continued innovations continue to advance in the field of cancer therapy and treatment, the number of alterations that could be acted upon is only anticipated to increase.

Comparing the Data

The data of this study, which included patients almost exclusively with either rare, refractory, or relapsed cancer, were compared with patient data from The Cancer Genome Atlas, which only includes data from patients that haven’t received treatment yet. The comparison was conducted among patients with seven different forms of cancer: bile duct, prostate, pancreatic, cervical, breast, lung, and colorectal.

The researchers were surprised by the fact that there really weren’t a lot of genetic differences between tumors that were refractory and those that hadn’t been exposed to any drugs. This makes it likely that sequencing would be best conducted at the first sign of metastasis (spreading of the cancer).

The findings of cancer tumors with multiple alterations makes the use of combination therapies more appealing. Certain combinations may be able to undermine a tumor’s ability to resist treatment effectively.

The findings highlight the reality that cancer treatment in the future will likely be determined by an individual tumor’s genetic makeup more than anything else, and this approach should ultimately lead to improvements in treatment outcomes. 

The full study can be found here in the Journal of Clinical Oncology.