Precision medicine takes personalized medicine to the next level, examining genetic makeup, cell proteins and many other factors that affect cancer development. It informs an accurate diagnosis, allowing for a precisely targeted approach to treatment.
What Is Precision Medicine
Personalized medicine and precision medicine are essentially terms describing the same treatment approach.
Precision medicine individualizes care to each patient and the complexities of their cancer. It is a way of looking at individual variables that influence a person’s disease process and then, tailoring treatment specifically to that individual for maximum effectiveness.
Most precision drugs target one of the many genetic changes that cause a normal cell to become
cancerous. Precision drugs also target proteins that have changed due to abnormalities. The treatments target the specific characteristics that make cancer cells cancerous.
Using molecular profiling to reveal information about a patient’s genetic and immune makeup helps match the patient’s tumor characteristics to drugs that will be the most effective. In molecular profiling, samples of tissue, blood or fluids are studied in a lab to search for abnormalities in genes, cell proteins and specific biomarkers of a tumor. It includes advanced bio-informatics and analysis of DNA, RNA, protein and immune factors. Environment and lifestyle are other important factors that may influence how an individual’s disease responds to specific treatments.
When Precision Medicine Is an Option
Every person and every cancer is unique. We focus on delivering the treatment that will result in your best outcome. That is why we offer more treatment options — to personalize your care. Precision medicine may be one of the approaches we offer.
Precision medicine is a treatment approach threaded through many of our disease-specific cancer programs. For instance, patients who have common cancers with a suspected genetic component, such as a gene mutation that causes lung cancer, are tested to identify whether or not a gene mutation is responsible for their cancer. Treatment is then directed to address the mutation.
If you are newly diagnosed with cancer, the experts in our disease-specific cancer programs can help you understand when and why standard therapies like chemotherapy, radiation therapy and surgery will be effective for your disease and when precision medicine techniques — or a combination of standard and precision medicine therapies — are needed.
A patient who has a rare or ultra-rare cancer or whose cancer doesn’t respond to standard treatment may be referred to the Rare Cancer and Precision Medicine Clinic to explore other options. A patient who has a tumor with atypical characteristics may also be seen in this clinic.
Precision Medicine Treatments
The following are examples of precision medicine cancer treatments.
- Immunotherapies help a person’s own immune system find and eliminate cancer. A person’s immune system normally detects and eliminates abnormal cells but the immune system can also get a boost from various types of immunotherapy. Some examples include:
- T-cell therapy, which involves extracting immune cells called a T cells from your immune system, modifying the cells in a lab and infusing the cells back into the bloodstream to fight cancer.
- Immune checkpoints, which are the body’s way of keeping the immune system from becoming too strong and attacking healthy cells and tissues. Checkpoint inhibitors are drugs that block this response, allowing the immune system to react more strongly against cancer.
- Treatment vaccines, which are different from vaccines that prevent disease, are another way to boost the immune system’s response to cancer cells.
- Gene therapy may be used when a person has genes that have become damaged. This damage is called a mutation, and it can cause a gene to malfunction and cells to grow uncontrollably. Gene therapy can replace a gene that is causing disease with a healthy copy of the gene, insert genes into cancer genes to allow standard therapies to eliminate them, or deactivate a gene that is malfunctioning.
- Radiation therapy technologies like MR-linac and proton therapy can be directed very precisely, adjusting for an individual’s anatomy to lessen side effects and damage to surrounding tissues. Molecular profiling can be used to determine whether or not a person’s particular gene signature (the activity of specific genes in cells or tissue) will make their tumor more or less sensitive to radiation.
- Targeted therapies are treatments that are formulated to attack a specific protein on a cancer cell that causes the cancer cell to grow and spread without control.
- An example is hormone therapy, which can stop formation of certain hormones or stop hormones from contributing to the growth of cancer cells.
- Surgery is individualized for each patient with the goal of eliminating cancer as completely and thoroughly as possible while avoiding disruptions to functional outcomes. Real-time image guidance, robotic guidance and 3D printing that custom-designs implants specifically for a patient’s unique anatomy are examples of patient-tailored precision surgery techniques.
Razelle Kurzrock, MD, FACP, medical oncologist, Rare Cancer and Precision Medicine Clinic, is a world-renowned leader in precision medicine and rare cancers research. Among several other distinctions, Dr. Kurzrock is the Chair for the Early Therapeutics and Rare Cancers Committee (SWOG NCI) — one of the largest clinical trials cooperative groups in the country — and has been the principal investigator for more than 100 early-phase clinical trials, leading eight life-changing drugs to FDA approval.
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