Targeted treatments for different types of cancer are becoming the medical standard these days and the keys that unlock it are a patient’s genes.
Allegheny Health Network has opened its new Clinical Genomics Laboratory in Pittsburgh to provide gene sequencing on site. The lab will provide next-generation gene sequencing based on blood or tumor samples from patients with metastatic, or late-stage, cancer and a variety of common early-stage cancers including breast, colon and lung cancer.
Genomic testing can provide information on what treatments will be most effective for each individual patient as well as provide insight into a patient’s prognosis and response to therapy. The new lab is located at AHN’s Federal Street office complex on Pittsburgh’s North Side.
“Genomics represents the future of cancer care from screening to prognostication to identifying the best treatments for an individual patient,” said Dr. David L. Bartlett, chairman of AHN Cancer Institute. “While testing can be performed through commercial labs, having it performed internally means that we can do it faster, better and less expensive. We can take advantage of the latest advances in DNA sequencing, screen for more mutations and perform research that will improve the impact of genomic sequencing in the future.”
What does genomics have to do with fighting cancer?
“Cancer develops due to mutations that occur in the DNA of cells which transforms them into cancerous cells without any regulation on growth and division,” Bartlett said. “Drugs are being developed that specifically target the mutations that cause the cells to go awry. In this way, the drugs can be most effective without having untoward side effects. The more we know about the mutations in a person’s cancer cells, the better we can apply treatments.”
Those new targeted therapies are complementing, or taking the place of, traditional chemotherapy treatments which can have widespread, debilitating side effects for cancer patients.
These new targeted therapies don’t work in every case or for every type of cancer, so not every patient will benefit just yet.
“At this point, there are still a limited number of mutations that we can target with new drugs, so it is not necessary to sequence or test every tumor in every patient,” said Bartlett, who added that he believes in the future, doctors will need to sequence every patient’s tumors and also blood samples. “We most commonly sequence tumor biopsies for mutation profiling but can now also perform sequencing on free DNA circulating in the blood as a ‘liquid biopsy.’
“Tumor cells shed their DNA into the blood,” he added, “and we can isolate and sequence that DNA as a means of avoiding a tumor biopsy which can be painful and/or risky.”
Bartlett said the advent of genomic testing and targeted therapies over the past several years has changed the face of cancer treatment likening it to each patient’s cancer having its own individual fingerprint.
“Therapy targeted to a specific mutation can be more effective with less side effects,” he said. “Data we receive from genomic profiling can also identify patients that can respond to immunotherapy which can lead to dramatic responses with minimal side effects. It does not help in every circumstance at this point, but we expect this to continue to evolve as we learn more about the genetic make-up of tumors and develop new drugs to target those mutations.”
The new lab helps patients with immediate cancer treatment and could also lead to huge research developments in the future.
“We believe that offering on-site genomic testing, as opposed to sending samples to an out-of-state lab, offers a number of advantages to our patients, including a quicker turnaround time an important advantage for patients who are eager to begin treatment – and better stewardship of our patients’ samples,” Bartlett said.
The research’s potential is enormously important, Bartlett said.
“We are embarking on a biomarker research project using DNA mutations from a blood test to rapidly determine whether a patient is responding to treatment,” he said. “The capabilities of our genomic facility will provide the opportunity for us to embark on research which will improve the lives of cancer patients.”