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Personalized Medicine

An assay that measures circulating tumor (ct) DNA in the urine can detect mutations in patients with a variety of advanced cancers, according to a recent study.
San Francisco, CA—A new genetic test may allow clinicians to improve their therapy decisions by better categorizing patients into specific subtypes compared with conventional immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) subtyping. According to data presented at the 2015 Breast Cancer Symposium, the BluePrint 80-gene assay reclassifies approximately 23% of tumors, allowing for more effective therapy selection, particularly in patients with triple-positive (HER2-positive/hormone receptor–positive) disease.
Boston, MA—Researchers have defined an 81-feature molecular signature to identify neuroendocrine prostate cancer (NEPC), an aggressive and rapidly progressing entity that is increasingly being recognized in patients with advanced disease and signals poor overall survival. The signature, derived from genomic, transcription, and methylation analysis, relies heavily on epigenetic alterations.
TMed will improve the selection of treatments by adding back and analyzing all the relevant data about the variability of response and the multiplicity of causes…from thousands, if not millions, of patients.
Philadelphia, PA—Now that a number of targeted therapies are available for the treatment of cancer, one of the big questions is how to best combine them, especially for patients with few other good treatment options. A preliminary study showed that combining the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib (Lynparza) with the investigational phosphatidylinositol 3-kinase (PI3K) inhibitor BKM120 achieved responses in 2 aggressive cancer types that share a genomic landscape—high-grade serous ovarian cancer and triple-negative breast cancer.
New Orleans, LA—Prostate cancer may soon have a new biomarker. The cell surface amino acid glypican-1 (GPC-1) was shown in a pilot study to have specificity of >70% for prostate cancer with a sensitivity of >30%, said Jonathan Henderson, MD, a urologist at Regional Urology in Shreveport, LA, at the 2015 American Urological Association meeting.
Philadelphia, PA—Although whole genomic sequencing can be done on a patient’s tumor, it does not mean that this will translate to a patient’s getting targeted therapy to identified genetic abnormalities, especially if that patient has pancreatic cancer.
Philadelphia, PA—In an era of personalized care, targeted cancer therapies are on the rise and are expected to reach nearly 60% of the global oncology and hematology drug markets by 2017. By testing for genetic biomarkers, physicians can predict patient response to cancer therapy and identify patients who will benefit most from these treatments, thus serving the 2 purposes of increasing the efficiency of treatment decisions and reducing the use of unnecessary drug prescribing and the associated costs.
Orlando, FL—An independent review of the literature suggests that 3 biomarker tests developed for prostate cancer have yet to justify their utility in randomized clinical trials. The 3 tests in question—Prolaris, Decipher, and Oncotype DX for prostate cancer—are being used in practices around the country, cost approximately $3500 per test, and are reimbursable by Medicare depending on the state.
Oncologists should be guided by the research that is being done around outcomes, benefit, and society impact when making value-based care decisions, says Dr. Stainthorpe.
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