Personalised medicine in metastatic colorectal cancer

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Published: 7 Dec 2012
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Dr Alberto Villanueva – Catalan Institute of Oncology – IDIBELL, Barcelona, Spain

Dr Alberto Villanueva talks to ecancer at the 2012 IDIBELL meeting in Barcelona about the need for further research and development of personalised medicine programmes across Europe.

Personalised cancer medicine is a situation in which now we receive one person who has a tumour, they get the sequence of his tumour and this is a great opportunity to make medicine but it’s also a great problem for the oncologists because we have hundreds of genes mutated but which will be the best approach to treat this tumour. Here we developed one strategy based on two basic concepts – orthoxenograft, that means a group of tumours implanted orthotopically in the same organ of origin of colorectal, ovarian and other types of tumours that are comprehensive, I mean representative of the disease, and use these orthoxenografts to define another is the CPMU, Central Personal Medicine Unit. That means we use this group of tumours to categorise influence on other driving mutations and to try to test in this CPMU, that’s an analogy with the CPU of one computer, to categorise here what is the best treatment that we can give to our patients. For a patient that will develop a tumour in the next month, the idea if we have the option to develop this CPMU, the idea is to get a biopsy of the tumour and do it in the month, more or less, that delay between surgery and treatment, get the tumour, get the whole genome sequence. We have to think about a funnel - we receive information and we have to get something. The idea is to use this funnel of machinery to offer the best treatment to the patient but based on the CPMU in the group of tumours that we have developed now.

I believe in personalised medicine but it’s very important to think in personalised medicine of two very important points. One, when we are thinking about personalised medicine implanted a tumour and to get a response from the same patient, first is the factor of implantation. In our case it’s very high but probably we cannot permit the option to lose 50% of the patients. And the second is the time delay between our result in mice and the time that we have to offer the treatment in the patient. Our approach is a step forward to make some realistic approach to offer, not to the best, best, best option for treatment but to improve the treatment that the patients now are receiving.

Do you think this will progress?

We have all the structure, we have the tumours, we spent almost eight years to arrive at this point and now we have all the machinery ready to use but it’s a matter of money. The idea for the institution is to just to begin it for two diseases, colorectal and epithelial ovarian cancer.