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…