Personalized Medicine 3.0 – Targeting Cancer – San Francisco State University spotlights progress towards individualized, targeted cancer diagnosis and treatment

 

 

As the common adage goes, cancer is not just one disease, but more like millions of individual conditions. If research continues along the directions many of the scientists speaking at San Francisco State University’s annual Personalized Medicine 3.0 conference predict, a cancer diagnosis may initiate a journey through a medical flowchart. Patients, geneticists, and oncologists will examine a person’s DNA makeup for thousands of possible variations which may affect the severity of his/her disease and the likelihood of its responding to particular pharmaceutical formulations.

 

Dr. Michael Goldman, chair of SFSU’s biology department, highlighted this emerging concept as the event’s theme while attendees enjoyed a luscious healthy fruit and pastry feast. Soon afterwards, David Duncan, author of Experimental Man and director of UC Berkeley’s Center for Life Science Policy, regaled us with tales from his genome. Duncan paid for complete analysis of his entire genetic makeup, which proved that he was basically healthy except for a predisposition to heart problems if he continued to gain weight. Responding to this news by losing ten pounds, Duncan advocated the potential positive consequences of learning more biologically about ourselves.

 

Other researchers continued the trend of linking basic science research to practical and clinical applications, including Dr. Steven Anderson, chief scientific officer of Monogram Biosciences/Labcorp, who took part in a panel discussion on diagnosing cancer. Anderson discussed mutation profiling of the DNA of cancer tumor cells to determine exactly which genes were altered or under/overexpressed in a particular person’s condition, with the pathology of four basic subtypes of breast cancer as an example. As a leader in the molecular oncology field, he helped develop many of the diagnostic assays making this level of genetic analysis possible, relying on molecular biology and immunology methods which identify mutations and gene expression levels.

 

Another panel speaker, Dr. Jeffrey Lawrence of Roche Molecular Systems, related how the pharmaceutical industry now works towards coordinating the development of diagnostic tests for one’s cancer subtype with the production of a specific medicine for its treatment. Also, Richard Shippy of Affymetrix, described new microassays which can detect the presence of certain alleles (particular forms of a gene) to identify a potentially pathological loss of genetic diversity in a patient’s cells. And, finally, just before lunch, Dr. Jerald Radich of the Fred Hutchison Cancer Research Center elucidated methods of determining the likelihood that a patient’s acute disease will return after a period of remission. The research he referenced held implications for metastatic melanoma skin cancer and acute myeloid leukemia, two types of cancer where medical science still has a long way to go when it comes to improving long-term survival rates.

 

After lunch and networking, the conference reconvened with a second panel discussion, this time concerning how upcoming healthcare financing reform in the United States might impact the clinical use of these emerging technologies. Carolyn Johnson of ABC News moderated a conversation among John Gaines, Director of Advanced Diagnostics Management with McKesson Corporation, Ryan Phelan, president and CEO of DNA Direct, Ronni Sandroff, editorial director of the Health and Family division of Consumer Reports, and Bill Welch, Managing Director of Skydeck Associates LLC. Highlights of the discussion included thoughts on how the personalized medicine paradigm might save money on cancer treatment as physicians will have a better idea of which drugs might actually help a particular patient and thus avoid prescribing unnecessary medication.

 

Panelists also brought up the need to streamline personalized-medicine guidelines for physicians through conducting detailed research, including long-term longitudinal studies of populations over time, and to build up public places to exchange healthcare information. Some industry representatives articulated the hope that with less government regulation, their firms would be able to work more creatively and effectively. Optimistic about the future of cancer research, they believed technological advances in drug development and delivery would make it possible to design workable, individualized medicine even for small segments of the population.

 

Other panelists cautioned about safety and the risk of overtreatment near the end of a patient’s life. Patients, and their doctors, understandably find it difficult to deal with having few treatment options left, and may continue to request medicine and procedures even with a very small chance they will prove beneficial. Individualized genetic profiling technology may lessen the demand for cancer treatments with limited utility. However, it also may cause distress for patients who discover they are susceptible to diseases we currently can do little to prevent or treat, or who become paranoid about relatively small health risks.

 

Next, Dr. Napoleone Ferrara of Genentech discussed the role of the Vascular Endothelial Growth Factor (VEGF) in promoting angiogenesis, or blood flow, to cancerous tumors. Therapies inhibiting VEGF-mediated vascularization of tumor tissue may help weaken the cancer growth in certain patients, as shown through some research on macular degeneration and other eye diseases, while other patients’ tumors may draw upon other sources to develop their blood supply.

 

Another luminary of basic research, Dr. Jackie Walling, vice president of clinical development at BioMarin Pharmaceuticals, provided a detailed overview of how exploration of DNA repair mechanisms remains relevant to cancer diagnosis and treatment. In the future, researchers may develop ways to treat tumors with DNA-damaging agents, enhance normal cells’ DNA repair mechanisms to prevent defects leading to cancer, and protect cancer patients from treatments which might themselves cause, or leave cells vulnerable to, genetic damage. Walling described certain genetic indications that a patient’s cancer might respond well to neo-adjuvant chemotherapy, administered before surgery, and how the information might spare some patients invasive surgical procedures. She also looked at the benefits and challenges of currently used clinical treatments related to DNA repair mechanisms, including breast cancer drug olaparib, which can prove effective but requires inconvenient IV dosing.

 

Finally, Dr. Martin Tenenbaum, a metastatic melanoma survivor himself, described with great enthusiasm his work with CollabRx. Tenenbaum founded CollabRx to aggregate and compile genetic information for cancer patients around the world, and then to record the patients’ responses to certain kinds of treatment. Ideally, with the computing power of the Internet and the large sample size, oncologists and patients will find the information they need to select appropriate genetic tests and pharmaceuticals. Questioned about potential employment and insurance discrimination for patients discovered to have a high risk of cancer lethality or relapse, Tenenbaum affirmed that safeguards could be developed to secure that information so that patients would not experience negative consequences for participating in CollabRx’s research work.

 

When asked about whether pharmaceutical companies would release proprietary information to this site, Tenenbaum replied that some new medicines only receive government safety approval nowadays when administered in conjunction with other therapies. So, working together can prove in the best interest of multiple firms.

 

Collaboration, among patients, physicians, oncologists, research scientists, academics, and business professionals, set the tone for the entire conference and possibly for the emerging culture of the new personalized-medicine paradigm. And people of all fields certainly enjoyed plenty of professional camaraderie, sipping ‘antioxidant beverages’ (red and white wines) while discussing new and old research pathways for conquering one of our most feared diseases.

 

San Francisco State University’s Department of Biology hosts the Personalized Medicine conference every spring as a fundraiser for the Department and as a chance to bring together students and research luminaries in the corporate and academic arenas. For more information, please visit the website: http://personalizedmedicine.sfsu.edu/

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