Genetic screening could allow for more personalized cancer treatments

Oncologists made strides this year toward the goal of personalizing cancer treatment. Several Stanford groups contributed to this effort with papers describing ways of identifying in advance how patients will respond to chemotherapy or radiation. This type of tool could pick out patients who need more aggressive treatment or who should receive experimental drugs if the standard drugs aren’t likely to help.

Both Jonathan Pollack, MD, PhD, assistant professor of pathology, and Ronald Levy, MD, the Robert K. and Helen K. Summy Professor, found groups of genes that distinguish people with more deadly cancers. Working in acute myelogenous leukemia (AML), Pollack found 133 genes that highlight patients with the most aggressive disease. Without such a test, he said these patients might receive standard chemotherapy that is unlikely to successfully fight their cancer.

Levy did his work in B cell lymphoma, finding six genes that may hold the answer to whether a person’s lymphoma is likely to respond to treatment. This work was in collaboration with Applied Biosystems, which hopes to market this six-gene test as the first genetic screen on the market for classifying cancers. “It makes a big difference in your treatment decisions if you think you have a high chance of success or if you don’t,” Levy said.

Gilbert Chu, MD, PhD, professor of medicine and of biochemistry, looked not at cancer treatment but at patient’s side effects in response to radiation therapy. This treatment is a powerful tool for treating cancer, but for 5 percent of patients that lifesaving treatment comes with serious side effects. Chu identified 24 genes whose activity may identify those most likely to react badly to radiation. Chu said patients likely to have few side effects can get stronger, more effective treatment, and those likely to have bad side effects may opt for alternative therapies.

Garry Nolan, PhD, associate professor of microbiology and immunology, searched for clues in how proteins interact with each other rather than in which genes are active. He reported a new technique for watching cells in people with AML that might help doctors to identify quickly patients who need stronger treatment or less common chemotherapy drugs.