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Estimates suggest one in two people will be affected by cancer in their lifetime. Thankfully genomics is set to improve cancer treatment options for people who have been diagnosed with cancer.
Normal cells become cancerous cells due to an alteration in their DNA that caused them to behave differently. In healthy cells there are genes that play a role in healthy cell growth, cell division and other normal cell functions. These healthy genes are called “proto-oncogenes” (from the Latin “proto” which means first or original, and “onco” which means tumor). If, however, these healthy proto-oncogenes become mutated and “switch on”, these malfunctioning genes become harmful, and are now called “oncogenes”. Following being switched on, these cells can start to grow and multiply unchecked, resulting in cancerous growths. Research has uncovered several different proto-oncogenes that can be “switched on” through a variety of different mutations, and to make matters a bit trickier, the same proto-oncogene with the same mutation might not behave the same way in two different people.
Traditionally, cancers have been treated depending on where in the body the tumor first appears; brain cancer is treated differently to pancreatic cancer for example. However, researchers studying oncogenes have discovered this is not always the most effective way to treat tumors. Let’s dive into an example and make up a fictional oncogene called “BAD”. Researchers have discovered that certain treatments work better than others in cancers where the BAD oncogene is activated. Now let’s say that in most people with the activated BAD oncogene, it results in stomach cancer. But what if someone has cancerous cells with the activated BAD oncogene, but it has caused lung cancer instead of the more common stomach cancer? Or what if someone has stomach cancer, but it isn’t caused by the BAD gene being activated, instead it is caused by another fictional oncogene, “AWF”? Genomic information about these cancerous cells could help doctors identify better treatment options for the patient that may not have been so obvious following traditional treatment approaches. Using genomic information to guide treatment decisions is a branch of medical research known as Personalized Onco-Genomics (POG).
POG allows researchers and doctors to identify exactly what genetic mutation is responsible for the cancer and treat it in the most effective and targeted way possible. So, without the benefit of POG, the person above with a tumor caused by the BAD oncogene in their lung (instead of the more common location in the stomach) would likely receive treatment designed for more common lung cancers, which would either be less effective, or not work at all. And the person with the stomach cancer caused by the AWF oncogene would, without POG, likely receive treatment for more common stomach cancers and may not receive any benefit from it. As you can see, POG can be used as a tool to support clinicians and help take some of the guess work out of treatment plans.
With the benefit of understanding which oncogene has caused someone’s cancer, the treating doctor could prescribe a treatment that is tailored to the genetics of the tumor, rather than the location of the tumor. In our made-up cases, the person with the cancer caused by the BAD oncogene would be treated with medication that targets the BAD oncogene, and the person with the cancer caused by AWF would be treated with the medication that works best for that oncogene, regardless of where in the body the tumor first appears. Another important benefit of POG will be that clinicians will be able to avoid prescribing medications with unpleasant side effects if they will not be effective treating cancer caused by a particular oncogene.
The use of POG is set to revolutionize the way cancer is treated, both here in BC, and around the world. Because there are still many oncogenes that have not yet been discovered we are pleased to help fund ongoing research that is currently being conducted by the BC Cancer Foundation and look forward to this tool becoming common place for cancer treatment in the years to come.