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Can diagnostics cure cancer ?

Originally posted on Linkedin

For the first time, we can be optimistic that we will win the war on cancer! Not with a magic bullet drug, but by genetically matching the tumor to a drug that actually works. Newly available immune therapies that harness the patient’s own immune system to attack the cancer have demonstrated prolonged disease-free progression. Each tumor develops in a unique way, therefore, better cancer diagnostics are needed to select those therapies which are most likely to benefit a given patient. Sequencing RNA can assist the doctors select the right drug for their patients by identifying which drug targets, including immune therapy targets, are present in each patient’s tumor.

Cancer diagnostics involves coloring tumor cells and visually inspecting them to determine the cancer type and stage. Fewer than 10 markers are routinely used with any given cancer to guide treatment.

The pathology report is then combined with other clinical information to plan treatment.

The inconvenient truth is that this approach does not provide the information needed to select an effective drug. As a result, only 1 out of 4 cancer treatments prolongs life.

Cancer is driven by genetic alterations that lead to unnatural cell growth. There are many different methods a tumor can use to grow, spread, and resist death, and these are reflected in that tumor’s unique genomic profile.

Several clinical studies have demonstrated that patients can live longer when treated with a drug based on broad genetic analysis of the tumor.

Today there are well over 1,000 “actionable” genes relevant to selecting cancer therapy.

RNA sequencing can identify which of these genes are active in a tumor and matches them to approved drugs and ongoing clinical trials for new drugs in development.

Most cancers are treated with chemotherapy, which kills all fast-growing cells: normal and cancer cells. Chemo has significant side effects and is only effective in 5% to 25% of patients, typically for only 6 months. In later-stage cancers, chemotherapy is generally unable to completely eradicate the cancer, resulting in high rates of progression and recurrence.

Matching the genetic alterations with specific drugs has proven to effectively prolong life even in late-stage cancers. Many trials have reported improved outcomes. The most exciting new type of treatment is immune therapy, which trains the patient’s own immune system to recognize cancer cells and kill them. Although this type of therapy has only been approved for two types of cancers so far, checkpoint inhibitors and many other immune therapies are in clinical development for all types of cancers.

Genomic Expression's OneRNA report provides a clinically actionable summary of the tumor expression profile.

A great success story is Dr Wartman who had a rare type of leukemia. He was  was also a researcher at Washington University, one of the largest sequencing centers in the US. He got his tumor sequenced and was able to find an over expressed gene for which there as a proven drug developed for kidney cancer. He took that drug and he is alive today.

We believe we can cure cancer, but not with better drugs alone! Newly available immune therapies that harness the patient’s own immune system to attack the cancer have demonstrated prolonged disease-free progression, but only in 15% to 50% of cancer patients. Some cancers with low mutation frequency do not respond well to immune therapy, however, there are now several novel approaches under investigation, which combine drugs to raise response rates.

Some targeted therapies are effective in 95% of patients, however, there are cancers that do not have access to targeted therapies today, such as triple-negative breast cancer, the majority of ovarian cancers, and liver and pancreatic cancers. Furthermore, most later-stage cancers develop resistance to standard therapies.

Each tumor develops in a unique way, and advancements in the use of more comprehensive cancer diagnostics are needed to select those therapies that are most likely to benefit a given patient.

OneRNA helps doctors select the right drug for their patients and pharma select the right patient for their drug, by using RNA sequencing to identify drug targets, including immune therapy targets, and link them to approved drugs and drugs in development.

We believe that an individual treatment plan can be developed for each patient, and this will be a true paradigm shift that will end the war on cancer and turn the disease into a manageable disease, and, for some patients, even provide a cure.

Not by a magic bullet drug, but by genetically matching the tumor to a drug that actually works.

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