Bringing Genome Sequencing into Cancer Care

Cancer treatment is broadly considered to be the frontrunner on the road to personalized medicine. A number of genetic tests exist to determine whether patients with different types of cancers are likely to respond to different drugs, and more examples are being discovered every day. Pharmaceutical companies are developing drugs targeted to some of these mutations, creating companion diagnostic tests to go along with the drugs.

Life Technologies, a global biotechnology tools company, aims to take this one step further. At the Consumer Genetics conference in Boston today, the company announced plans to sequence the genomes of cancer patients who have failed to respond to different drugs and use the results to shape treatment. For example, the tumor of a patient with ovarian cancer might possess a mutation that renders the cancer susceptible to a certain drug that is most commonly found in lung cancer. Physicians could then prescribe that drug, normally used only for lung cancer, off-label.

“This is a groundbreaking initiative for oncologists and their patients that should demonstrate how whole-genome sequencing with analytics and counseling can identify a treatment plan customized specifically for each seriously ill patient,” said Paul Billings, director and chief scientific officer of the Genomic Medicine Institute at El Camino Hospital, in a statement from Life Technologies. Billings will serve as the project’s chief medical officer. “There is an urgent need to define and validate a complete medical workflow for genomic-based cancer care.” Life Technologies, which was created by the combination of Invitrogen Corporation and Applied Biosystems, sells one of the most popular DNA sequencers on the market. The new study, called the Genomic Cancer Care Alliance, is a collaboration between Fox Chase Cancer Center, the Translational Genomics Institute, and others.

According to the statement:

As currently envisioned, patients enrolled in the study will have both tumor and normal tissue sequenced by TGen, Scripps, and other organizations, using Life Technologies’ Applied Biosystems SOLiDT System to identify mutations…

The results will be validated by a CLIA-certified lab and interpreted by TGen and Omicia Inc, a personalized medicine company focused on interpreting genome sequences for clinical applications. A centralized tumor board for the study, composed of physicians from Fox Chase Cancer Center, TGen, Scripps and El Camino Hospital’s Genomic Medicine Institute, will study the results and consult with patients’ oncologists regarding how to use the test results to develop personalized care plans. Scripps Genomic Medicine, a program of the nationally renowned Scripps Health organization, is focused on using genetic information to create individual treatment plans.

Similar, more limited efforts are underway at individual hospitals around the country. Massachusetts General Hospital, for example, tests lung cancer and colorectal cancer patients for a number of mutations, using the information to select treatments or to enroll patients in clinical trials of experimental drugs.

Scientists have sequenced hundreds of cancer genomes in the last year, though only a handful have been published to date. One difficulty has been distinguishing the so-called driver mutations, which enable cells to become cancerous, from mutations that have no impact on the cell. The number of mutations found in different cancers appears to vary widely.

The project follows a more focused pilot project sponsored by Life Technologies announced a couple of months ago, which involves sequencing the genomes of 14 patients with triple-negative breast cancer, an especially serious form of the disease that is resistant to some of the most successful drugs. They will use the genome to guide treatment and then determine if that improves outcomes compared to 14 breast cancer patients who did not have their genomes sequenced.