Systems medicine approach to optimise drugs and drug combinations for individual AML patients

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Published: 26 Jun 2014
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Dr Olli Kallioniemi - University of Helsinki, Helsinki, Finland

Dr Kallioniemi talks to ecancertv at WIN 2014 about using a systems medicine approach to optimise drugs and drug combinations for individual patients with acute myeloid leukaemia.

I was presenting on our large scale grand challenge programme of systems medicine in leukaemia, acute myeloid leukaemia in particular. The programme is about trying to predict and test the drug sensitivity of patient cells and try to tailor therapies to individual patients.

Why do drugs and drug combinations need to be individualised in patients with acute myeloid leukaemia?

We know that AML is an enormously heterogeneous disease, genomically and phenotypically. This is now almost the first time that we can actually start to see how individualistic the drug responses are also from one patient to another. So there’s a tremendous opportunity here to tailor therapies from the current uniform chemotherapy-oriented drugs as they are being used in the clinic today.

What were some of the main points of your talk?

One thing is that the systems medicine approach, as such, is important; that we get samples from patients at diagnosis, at remission, at relapse and try to compare them with one another. The second point is that this drug sensitivity testing adds a lot to the profiling of cancers. So rather than just doing genomic profiling as most people do, if we can directly determine the sensitivity of patient cells ex vivo to a range of drugs, we screen 300 drugs, this can help to identify novel drug combinations and opportunities for patient treatment which we also demonstrated by tailoring patient treatments accordingly. These results also highlight the significant genomic heterogeneity of leukaemia, that out of the patients who have received these novel therapies we obviously have not, in late stage chemo-refractory disease, been able to cure anybody but we get excellent responses but the tumours come back. After analysing these recurrent tumours we can identify new treatment opportunities again. So this is why this systems medicine approach that you analyse it once, you see what happens, you review the situation again and you try to optimise the treatments in successive cycles for each patient.

What was the take home message from your talk?

Systems medicine is becoming to be the future of cancer treatment so it’s just not about diagnostics of genomic alterations, we need to understand cancer in a more deeper way and maybe this type of testing could be a future diagnostic approach for patients with leukaemias, maybe later on solid tumours as well.