Personalized medicine offers patients therapies that are specifically targeted against the unique composition of their tumours
New clinical protocols for taking biopsies of malignant tumors at different stages of their growth are being developed by oncologists at the Segal Cancer Centre at the Jewish General Hospital, along with colleagues in the Quebec – Clinical Research Organization in Cancer (Q-CROC). This next-generation biobanking will enable researchers to accurately study and compare how the genetic composition of cancer cells evolves over time and leads to resistance to drug therapies. This will assist physicians in prescribing a course of treatmentthat targets the molecular foundation of a patient’s cancer and to adjust those treatments according to changes in the make-up of the disease.
“The distressing reality is that metastatic solid tumours are almost never curable because they become progressively resistant to serial drug therapies; there seem to be no signs on the clinical horizon that might provide a way to overcome this issue,” writes Dr. Mark Basik, an oncologist at the Segal Cancer Centre, in the latest issue of Nature Reviews Clinical Oncology. “Clearly, now is the time to focus attention on the molecular analysis of recurrent, metastatic, and drug resistant tumours.”
The advent of personalized medicine is a reflection of the growing body of evidence that cancer cells mutate in various and unpredictable ways in their struggle to survive in the face of therapies deployed against them. As this occurs, drugs gradually lose their effectiveness and patients eventually succumb. Great advances in analytic technology, along with accelerated drug development and a growing understanding of tumour heterogeneity, have resulted in next-generation biobanking, which calls for serial biopsies to monitor changes in metastatic cancer over time.
With the realization that each cancer has the potential to run a distinct course, there is a growing demand for multi-centre studies. They provide the capacity for comparative analysis of larger numbers of tumour samples, thereby increasing the data available to identify therapies most likely to be effective for each patient. In a paper published in the latest edition of Modern Pathology, Dr. Gerald Batist, Director of the Segal Cancer Centre, and his colleagues propose a standardized protocol for performing needle core biopsy, in this case for liver cancer.
“It is a complex process, requiring detailed work-flow across a variety of disciplines, to ensure the quality and usability of patient specimens,” acknowledged Dr. Batist. He is, however, clear that next-generation biospecimens represent the future of cancer research and treatment over the coming decade.
The Segal Cancer Centre is an international leader in offering personalized solutions for patients. Along with its partners in Q-CROC and others, it is paving the way for multicentre collaborations and biobanking to increase the data upon which researchers can draw for clinical applications. Its capabilities to perform genetic analyses of tumours will be significantly enhanced next year with the opening of its Molecular Pathology Centre, which will be the core facility for collecting, analyzing, and preserving malignant tissue samples.
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Research Communications Officer
Lady Davis Institute
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July 22, 2013