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How Personalized Medicine Is Changing: Breast Cancer

How Personalized Medicine Is Changing: Breast Cancer | Complex Systems and X-Events | Scoop.it

In 2011, a 52-year-old runner and yoga enthusiast walked into the office of Monica Loghin, a neuro-oncologist at MD Anderson Cancer Center in Houston, complaining of numbness and weakness in her lower limbs and difficulty controlling her bladder.

 

The symptoms were of grave concern, as the patient had previously undergone surgery for breast cancer that had spread to her brain. If such a cancer returns post-surgery, that is often a sign the patient doesn’t have much time left.

 

An MRI confirmed that the breast cancer had again spread to the woman’s cerebrospinal fluid. Loghin ordered testing of that fluid to see if the patient might have certain biomarkers that could be targeted by existing drugs. (A biomarker is a DNA sequence or protein associated with the disease; different biomarkers can suggest specific treatments, depending on the disease and other factors.) She asked for tests that could detect tumor cells circulating in the blood.

 

The cancer cells in the fluid bathing the woman’s spinal cord and brain chambers did, in fact, have a lot of the protein that controls a glucose (sugar) transporter that drives cancer cells. The cancer cells in the fluid also had a lot of HER2, a protein associated with aggressive breast cancers but also treatable with a drug called Herceptin (trastuzumab). The drug is usually taken intravenously, but Loghin had heard of a couple of cases in which Herceptin was delivered directly into the cerebrospinal fluid via a flexible tube, or catheter. The patient agreed to this experimental treatment.

 

It took only a week for the news to improve. After the first infusion of Herceptin, the patient’s cancer numbers were down. Within a few weeks, her cancer cell numbers had fallen so low that her immune system had begun to take over, clearing out the remaining cancer cells. Nearly two and a half years later, the patient is still alive and well enough to do yoga. Another MD Anderson patient who had a similar disease profile and therapy is also alive and well one year after treatment.

 

This case outlines the dream of personalized medicine: A disease is analyzed at the molecular level. The analysis identifies a drug target. The drug gets delivered where it needs to go. The patient gets better. And while this hopeful scenario has yet to become commonplace, it is becoming more and more the norm for many breast cancer patients.

 

 

More at http://genomemag.com/how-personalized-medicine-is-changing-breast-cancer/#.U72NDPmSyW3 ;
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Rescooped by Roger D. Jones, PhD from healthcare technology
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Personalized Medicine Best Way to Treat Cancer - Study

Personalized Medicine Best Way to Treat Cancer - Study | Complex Systems and X-Events | Scoop.it

“If you’re dealing with a disease like cancer that can be arrived at by multiple pathways, it makes sense that you’re not going to find that each patient has taken the same path” - John McDonald, a professor in the School of Biology at the Georgia Institute of Technology in Atlanta.

 

If a driver is traveling to New York City, I-95 might be their route of choice. But they could also take I-78, I-87 or any number of alternate routes. Most cancers begin similarly, with many possible routes to the same disease. A new study found evidence that assessing the route to cancer on a case-by-case basis might make more sense than basing a patient’s cancer treatment on commonly disrupted genes and pathways.


The study found little or no overlap in the most prominent genetic malfunction associated with each individual patient’s disease compared to malfunctions shared among the group of cancer patients as a whole.
“This paper argues for the importance of personalized medicine, where we treat each person by looking for the etiology of the disease in patients individually,” said McDonald, 

 

“The findings have ramifications on how we might best optimize cancer treatments as we enter the era of targeted gene therapy.”


The research was published February 11 online in the journal PANCREAS and was funded by the Georgia Tech Foundation and the St. Joseph’s Mercy Foundation.


In the study, researchers collected cancer and normal tissue samples from four patients with pancreatic cancer and also analyzed data from eight other pancreatic cancer patients that had been previously reported in the scientific literature by a separate research group.


McDonald’s team compiled a list of the most aberrantly expressed genes in the cancer tissues isolated from these patients relative to adjacent normal pancreatic tissue.


The study found that collectively 287 genes displayed significant differences in expression in the cancers vs normal tissues. Twenty-two cellular pathways were enriched in cancer samples, with more than half related to the body’s immune response. The researchers ran statistical analyses to determine if the genes most significantly abnormally expressed on an individual patient basis were the same as those identified as most abnormally expressed across the entire group of patients.

 

The researchers found that the molecular profile of each individual cancer patient was unique in terms of the most significantly disrupted genes and pathways.

 

more at http://www.news.gatech.edu/2014/02/24/personalized-medicine-best-way-treat-cancer-study-argues

 


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Emma Pettengale's curator insight, September 9, 2014 10:15 AM

“If you’re dealing with a disease like cancer that can be arrived at by multiple pathways, it makes sense that you’re not going to find that each patient has taken the same path” - John McDonald, a professor in the School of Biology at the Georgia Institute of Technology in Atlanta.

Sophia Nguyen's curator insight, July 18, 2015 7:47 AM

Cancer research is something I'm particularly interested in and would try to go into someday and I found this interesting because it shows how medicine has evolved and becoming more personalized.

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Personalized Immunotherapy for Leukemia Named Breakthrough Therapy

Personalized Immunotherapy for Leukemia Named Breakthrough Therapy | Complex Systems and X-Events | Scoop.it

A University of Pennsylvania-developed personalized immunotherapy has been awarded the U.S. Food and Drug Administration’s Breakthrough Therapy designation for the treatment of relapsed and refractory adult and pediatric acute lymphoblastic leukemia (ALL). The investigational therapy, known as CTL019, is the first personalized cellular therapy for the treatment of cancer to receive this important classification.


In early-stage clinical trials at the Hospital of the University of Pennsylvania and the Children’s Hospital of Philadelphia, 89% of ALL patients who were not responding to conventional therapies went into complete remission after receiving CTL019.


The investigational treatment pioneered by the Penn team begins by removing patients' T cells via an apheresis process similar to blood donation, then genetically reprogramming them in Penn’s Clinical Cell and Vaccine Production Facility. After being infused back into patients’ bodies, these newly built “hunter” cells both multiply and attack, targeting tumor cells that express a protein called CD19. Tests reveal that the army of hunter cells can grow to more than 10,000 new cells for each single engineered cell patients receive.


source: http://www.dddmag.com/news/2014/07/personalized-immunotherapy-leukemia-named-breakthrough-therapy

 


more related articles on this :

http://www.chop.edu/service/oncology/pediatric-cancer-research/t-cell-therapy.html

 

http://online.wsj.com/articles/novartis-wins-breakthrough-status-for-new-leukemia-treatment-1404758105

 

http://www.novartis.com/newsroom/media-releases/en/2014/1816270.shtml

 

 


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