Precision Medicine: A Targeted Treatment Approach

When President Obama unveiled the launching of a national precision medicine initiative during his 2015 State of the Union address, an opportunity was presented to expand a collective knowledge about what we know about treating cancer.  Rutgers Cancer Institute of New Jersey has been at the forefront of such cutting-edge science and aims to leverage funding made available through this national initiative to continue collaborative efforts to personalize cancer therapies for patients.

At Rutgers Cancer Institute of New Jersey, investigators are using DNA analysis to find targeted therapies for cancer.  Known as ‘precision medicine,’ this sequencing approach looks for and examines abnormal changes from 50 to more than 400 genes.  Once identified, specific treatments can be aimed at these abnormalities or mutations, which are responsible for the growth of cancer cells. “It’s building a better bulls-eye,” notes Lorna Rodriguez, MD, PhD, director of precision medicine oncology at Rutgers Cancer Institute. “We are learning that therapies designed for and approved to treat one form of cancer may be effective in treating other forms of cancer based on changes or alterations in one’s DNA. Through our research at Rutgers Cancer Institute, we are finding an average of five mutations through the sequencing process. This results in the possibility of identifying additional treatment options. In the case of those with a rare cancer where there is no standard therapy or those with cancer whose disease has stopped responding to traditional treatment, this targeted approach can afford alternate options,” she notes. 

Shridar Ganesan, MD, PhD, associate director for translational science and chief of molecular oncology at Rutgers Cancer Institute, is leading a clinical trial at Rutgers Cancer Institute that uses DNA analysis to examine rare cancers and those resistant to traditional therapies.  He notes the sequencing is a different approach to identifying treatment. “In recent years we have learned that cancers that arise in one organ, such as breast cancer or lung cancer, are not just one disease, but rather a collection of distinct diseases with varying responses to different treatment strategies. We therefore need to examine many features of each cancer to better classify it and identify effective treatment,” reported Dr. Ganesan. 

But DNA sequencing alone doesn’t lead to alternate therapies. Once the analysis takes place and abnormalities are identified, the findings are discussed at a weekly meeting of the precision medicine molecular tumor board, which comprises radiation, surgical and medical oncologists; pathologists; basic scientists; systems biologists, and those with computational expertise. The team decides if the results from the DNA sequencing suggest new therapy options, which could include medicines already approved by the U.S. Food and Drug Administration – even if they’re designed for diseases other than cancer.

The precision medicine approach also gives doctors an opportunity to offer patients enrollment into existing clinical trials. Early results seen from Dr. Ganesan’s clinical trial for rare and hard to treat cancers have resulted in the development of additional clinical trials at Rutgers Cancer Institute that target DNA changes. Learn more about this precision medicine clinical trial. 

View all precision medicine clinical trials currently available through Rutgers Cancer Institute

Collaborating on the Best Care

While precision medicine efforts are being carried out at the nation’s top cancer facilities, including Rutgers Cancer Institute, these centers are forging collaborations to ensure rapid discovery and dissemination of scientific findings. For instance, a collaborative effort between Rutgers Cancer Institute and RUCDR Infinite Biologics® within the Human Genetics Institute of New Jersey at Rutgers supported by a $10 million anonymous gift is being enhanced.  The collaboration is enabling investigators to identify the drivers that make a tumor cancerous and target therapies to these abnormalities in a more rapid fashion than ever before.

More broadly, Rutgers Cancer Institute is part of the Oncology Research Information Exchange Network (ORIEN), which comprises top cancer centers across the nation. With a focus on ‘Big Data’ and information sharing, the ORIEN initiative encourages member cancer centers to come together to use one protocol known as Total Cancer Care®. Through this study, consented patients agree to donate their tissue and clinical data for research to understand cancer at the molecular level. Importantly, patients are followed for life; if new drugs are identified that would match with a patient’s mutation, that patient will be notified.