If we want to defeat cancer, we have to treat every patient uniquely, a team from the National Cancer Institute (NCI) concluded. They announced the trial of a new type of cancer test - one that is designed for the patient, not for a specific condition.
"This is really the first time in a very large way that patients will be screened for mutation irrespective of the site of origin of their tumour," NCI deputy director James Doroshow said. "And feed it with a drug that is presumed to be effective against that particularly molecular change."
The trial will include around 1,000 patients who have cancer in advanced stages and who have tried conventional treatment without success. They will either be given experimental drugs not available on the market, or medicine approved by the US Food and Drugs Administration (FDA) that is currently used for other treatments in order to see what mutations they undergo.
"What we don't know is how well this approach will work in terms of defining which therapy is best; what we are quite sure about is that we will be obtaining new tumour biopsies prior to the initiation of treatment," he said. "We will very likely find out a great deal about how, when drugs don't work and why they don't work. Because we will be doing a very deep larger analysis of all these tumours that we screen."
This is a technique called precision medicine - a medical model that proposes the customization of healthcare—with medical decisions, practices, and/or products being tailored to the individual patient. According to the National Research Council, Precision Medicine refers to the tailoring of medical treatment to the individual characteristics of each patient. It does not literally mean the creation of drugs or medical devices that are unique to a patient, but rather the ability to classify individuals into subpopulations that differ in their susceptibility to a particular disease, in the biology and/or prognosis of those diseases they may develop, or in their response to a specific treatment.
Researchers believe precision medicine can be applied with success in cancer treatment.
"This is one of the first trials to try and discover if this is a good approach," Dr Doroshow said. "I don't think it will yet define that this is unequivocally the best approach, but I think we will learn a great deal [about] how to do these genetically based research programs. Then from there [we can] understand in what circumstances this approach is actually better or perhaps not better than the current approaches."