March 27, 2015 | by Tami Dennis
Precision medicine holds promise – on that doctors, especially cancer specialists, can agree. But this sophisticated approach to treatment, which incorporates knowledge about a person’s genetic profile, environment and lifestyle, isn’t yet standard for all cancers. It can’t be. Researchers and scientists are still amassing as much information as possible, in order to better understand the best avenues of research and the resulting treatment options.
The National Institutes of Health (NIH) sums up the status of precision medicine in this way: “While significant advances in precision medicine have been made for select cancers, the practice is not currently in use for most diseases. Many efforts are underway to help make precision medicine the norm rather than the exception.”
Steven T. Rosen, M.D., provost and chief scientific officer at City of Hope, is an expert on precision medicine, understanding the potential that comes with increased knowledge of diseases such as cancer and what it will take to help the field evolve.
Here he answers questions about the current, and future, state of precision medicine at City of Hope:
Do institutions like City of Hope do genetic profiling of every cancer patient?To that end, City of Hope has made a commitment to, in Rosen’s words, “share data, collaborate and to ultimately change the cancer treatment model.”
City of Hope selects molecular tests for a limited number of patients at this time, depending on their type of cancer and how likely the tests are to be useful in their particular case. Such testing will become increasingly common, however, as the knowledge of genomics grows and is shared and applied among clinicians and researchers.
Which types of cancers/patients are generally profiled, and why?
Doctors currently profile patients who have failed traditional therapies in their search for a rational treatment consideration. Sometimes that profile points to an appropriate medication; sometimes, regrettably, it doesn’t. With more funding and attention to precision medicine, however, the number of ‘hits’ will grow exponentially.
How does genetic profiling influence your approach to clinical management?
Molecular/genomics testing may identify a reasonable therapeutic target, but identifying the target does not guarantee we will have a medication that exists or is available for the patient. That ability to better connect medications with molecular targets is the power of precision medicine. It will open the door to new and improved treatment options for clinicians and patients around the world.
What’s next for precision medicine?
Rapidly evolving science and modern diagnostics are moving the field of cancer research and cures forward, but it’s not something one institution can accomplish on its own.
To maximize the number of targets and help make, as the NIH says, “precision medicine the norm rather than the exception,” City of Hope has teamed up with the Patrick Soon-Shiong Institute for Molecular Medicine and the Oncology Research Information Exchange Network, or ORIEN, to accelerate the translation of knowledge into treatments. Through the Patrick Soon-Shiong Institute for Molecular Medicine, institutions will quickly share knowledge and research breakthroughs with their counterparts across the country. Through ORIEN, participating cancer centers will be able to more quickly match patients to potentially lifesaving clinical trials.
As the current state of medicine shows, precision medicine is already here. As these initiatives show, the next step is to bring it to everyone.
Learn more about becoming a patient or getting a second opinion by visiting our website or by calling 800-826-HOPE (4673). You may also request a new patient appointment online. City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.