Research trials at U-M personalize cancer treatments

Curtis Huntington was diagnosed nearly three years ago with stage 4, advanced-stage prostate cancer.

Instead of getting treated with a conventional therapy used on most patients, Huntington participated in a research effort at the University of Michigan that uses genetic information to tailor treatment to his unique cancer.

He has since taken part in three clinical trials, and so far his prognosis is good.

"Being able to tailor treatment gives you a chance to treat your illness, not just an illness," said Huntington, 70, a U-M math professor. "I have a particular form of cancer, unique to me. If we can treat my form of cancer, that's great."

Huntington is involved in research that some say is the next frontier in medicine, known as personalized medicine. Since last year, U-M researchers have sequenced the DNA of tumors from more that 100 metastatic cancer patients who are no longer responding to usual therapies. The effort is to help doctors customize treatment based on evolving technologies and discoveries in DNA profiling.

Traditionally, patients get treated for diseases with what is available and works for the masses. Personalized medicine aims to customize treatment for every individual, based on their genetic information and other factors. It's a young but hot area in medical research, one that's expected to usher in a new era of treatments, possibly even add a new paradigm.

U-M has been involved in the research for years and is moving toward translating it into medicine, initially focusing on cancer.

"This is about as cutting edge in medicine as you can get," said Dr. Robert Penny, an adjunct associate professor in U-M's Department of Pathology. "For every disease out there, this is the future."

Research to expand

Penny is CEO of Paradigm, a nonprofit company that U-M began last summer in collaboration with Phoenix-based International Genomics Consortium.

The venture offers gene sequencing and molecular diagnostics to help tailor treatment for individuals. Sometimes the treatment involves an experimental drug being used in a clinical trial. Other times, patients can be put on an agent that is known to be effective at working on a specific DNA, or on a protein change, in cancer.

The company will soon be rolling out tests to be used in clinical trials.

The research initially is focused on cancer, because so much is known about DNA-level changes in cancer. But eventually, DNA sequencing will evolve to other diseases.

"This has really has been a revolution that we have been pushing for to happen so we become granular, more specific, on how we sort through patents, and who will respond to a particular therapy," Penny said. "We all want to get the right drug to the right patient at the right time."

The work complements other work under way at U-M involving sequencing of DNA.

Dr. Arul Chinnaiyan is director of the Michigan Center for Translational Pathology, which is working to develop new molecular tests and therapeutics for human diseases, with a focus on cancer.

Not all patients respond to conventional treatments, so when they reach advanced stages of cancer they are enrolled in a clinical sequencing program.

Since 2011, U-M has sequenced 150 adult patients and 15 children, Chinnaiyan said. The six-week process sequences the cancer tumor along with normal tissue and compares them.

"We're trying to figure out what mutations have occurred in the patient's tumor relative to the normal genome," Chinnaiyan said. "We analyze the data in the context of the mutation to see if there are any clinical trials that might be appropriate or approved drugs that might work."

A small percentage of patients fit the criteria for clinical trials or approved drugs, and an even smaller percentage will respond. But early research has offered some success stories that will be published in academic journals in the near future.

"Patients who have failed conventional therapies are looking for options," Chinnaiyan said.

'Reshaping cancer care'

Ultimately, the hope is to understand the genome of the cancer and what is driving it, and to sequence tumors sooner so patients can get more specific treatments sooner.

"In the future, this is the way that cancer and other diseases will be handled," Chinnaiyan said.

U-M joins several research institutions across the country that are working to translate personalized medicine into patient care, said Edward Abrahams, president of the Washington, D.C.-based Personalized Medicine Coalition.

The declining cost of sequencing, combined with the better understanding of genetics, especially genetic expressions of cancer, is providing better care for treatment, Abrahams said.

"It's the latest trend in significant research in oncology, and it is reshaping cancer care," Abrahams said. "We're trying to get away from one-size-fits-all, trial-and-error medicine ? and it has enormous implications for the future of medicine."

kkozlowski@detroitnews.com

(313) 222-2024

Source: http://www.detroitnews.com/article/20130218/LIFESTYLE03/302180334/1040/rss34

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