MARKERS, MARKERS, WHERE ART THO?

I’ve talked about personalized medicine – the goal of which is to target the specific mutations in a patient’s cancer call as the delivery point for a chemical intervention. If I have a mutation here, I use drug X. A mutation there, drug C. And so on…. The idea is to get the right drug to the right patient (not, by the way, the right patient to the right drug as one AACR pharma exhibit proclaimed). And it makes perfect sense – hit your cancer cell where it’s weakest and destroy it.

So I ask, especially those of you who are ePatients: where is your cancer cell weak?

I don’t know either. That’s just it. Unless we undergo genomic testing (not cheap, not always helpful, and certain universities sometimes lose your tissue), we don’t know where our mutations, where our weak spots lay, where there is a chink in the cancer cell’s armor.

What we need are biomarkers – reliable indications from easily obtainable sources (think blood rather than tumor) to indicate that a particular biological process is occurring. In cancer the goal is to be able to identify those people who are most likely going to find success with a given drug. If we see a mutation in the WHT pathway, we give a drug targeted there. If we see the PIK3 pathway has gone awry, we leverage that. And ideally those are blood samples, since we’re constantly giving blood samples anyway.

These aren’t perfect systems – I know that. And tumors can still develop resistance to drugs. But imagine if therapies were no longer given “Russian roulette” style – waiting for one to take hold. Imagine how our success rates might soar, how side effects would diminish, how much money would be saved.

This is good, right? And we’re inching our way there – we really are. It’s a race against time…

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2 Comments (+add yours?)

  1. karen sutherland
    May 31, 2014 @ 21:41:54

    dear Lori. thanks so much for this excellent post! I will see both the gyno/onc/sugeon who did my hysterectomy last august (st.III uterine ca with mets to cervix), and later in the week, the MBC oncologist. they both are always extremely informed, and though I don’t even want to think about a recurrence of either cancer – I have been trying to formulate questions about what course to take if either (or BOTH should rear their ugly heads I know you will understand just why the hell my mind sometimes takes me to those places!) should recur. at least, I want them to know it is important to me to keep informed of all the best options. the biomarkers of the blood – oh, if only! but I feel more empowered and prepared to discuss both types of testing, including genomics. I will have my first scan since completing tx for the uterine ca – hope it turns out to be a somewhat moot issues, but I still want to discuss what-ifs.

    gratefully and with much love,

    Karen PS – have you heard any more of where your tumor block is?

    Reply

    • Lori
      May 31, 2014 @ 22:29:47

      I am holding oodles of healing thoughts for you with you’re upcoming appointments. One of the things I find so wonderful about our community is how much we have learned and can share collectively. And the fact that we are always there to support one another!

      Tumor block – not so much. They are going to try and work with existing slides, which is an answer, but not THE answer!

      Sending you love and light,
      Lori

      Reply

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