AACR Annual Meeting 2013
Next generation gene sequencing
Dr John Mendelsohn – MD Anderson Cancer Center, Houston, TX, USA
The Khalifa Institute is a brand new institute, well, three years old at the moment, but you’re doing exciting things. What exactly are you doing in this new study of sequencing; what have you achieved so far?
Our goal is over the next five years to set up the infrastructure and then do the research that eventually will allow us to interrogate every patient’s tumour at MD Anderson if standard therapy isn’t curing them to find out what the genetic or RNA or protein abnormalities are in the tumour that will allow us to give targeted therapy to the patient.
How much evidence do you have that the idea of doing gene analysis, looking at pathways and analysing the individual patient will actually work in refining therapies?
Well that’s a wonderful question. Back in 1980 when I first got into this field we didn’t have much evidence but we and others began to develop therapies that targeted the products of the genes that cause cancer. The real breakthroughs occurred in the late ‘90s and in the past decade when there’s at least a half a dozen examples now of major changes in life outlook and prognosis when targeted therapies have been given to patients with cancer where the target is the product of a mutated or abnormally functioning gene. So we’re confident that this approach which, if we can mine it properly and direct it for each patient to the gene or genes that are causing his or her cancer to act the way it’s acting, we’re confident this will change outcomes.
And what have you achieved so far in your sequencing study at the Khalifa Institute?
So right now we have just begun a trial which involves taking the patients who have advanced cancer and have failed other forms of therapy and sequencing their tumour, usually looking at hotspots, they’re called, with genes where there are actionable steps we can take because of drugs available. And we’re putting patients on these targeted drugs based on this information and beginning to collect the data. We’ve got to show that this works; this is all research, it’s paid for with philanthropy and hospital margins and the sweat, blood and tears of volunteers. We have to show this works so that it becomes part of standard of care. And that’s really one of the goals of the Khalifa Institute.
Right, what’s your message, then, to busy cancer doctors out there on this topic?
The message is that for certain cancers, and part of it is an education process, it should be standard of care to check genes in order to assign therapy. And where this isn’t the standard of care refer your patient to an institution, and we’re not unique in this, this is going on in many cancer centres, so that we can get the data and show in general that this works and it will become standard of practice, I think, at all oncology practices.
And this is because you believe personalised cancer medicine has got a real future yield in improving outcomes and quality of life?
Yes, yes, and I think that there are many ways to improve death rates in cancer. One of them is prevention, another is stop smoking. I always want to say that because 30% of cancer deaths are due to the effects of cigarette carcinogens. But I believe that targeted therapy is an important added dimension now in approaching cancer care and we’re going to increase the cure rates.
John, thank you very much.