Cancer medicine is moving towards understanding what drives each particular patient's cancer. But not every patient has had access to this level of individualized care. Today, Thomas Jefferson University announced its ability to provide routine genomic fingerprinting to cancer patients, giving patients and physicians the information they need to make the most appropriate treatment decisions based on each patient's individual cancer.
"What differentiates Jefferson is that genomic analysis - which gives us a clear view of a patient's tumor - will now routinely be offered to every patient that would benefit from testing," says Karen Knudsen, Ph.D., Director of the Sidney Kimmel Cancer Center at Thomas Jefferson University. Jefferson will combine genomic analysis with other analytical tools in order to give physicians the most complete and actionable picture of a patient's cancer.
Cancers originate from normal cells in the human body and then acquire numerous mutations that alter their original function and grow without boundaries. Only a small percentage of cancers arise because of hereditary gene mutations that are passed down from the parents (patients with the BRCA1 or BRCA2 mutations, for example). All cancers, however, are driven by an often unique set of mutations that are acquired, and those mutations can change over time, making it especially important to precisely define a patient's genomic fingerprint and treat him or her according to the genes that drive that particular tumor.
Jefferson's Sidney Kimmel Cancer Center, one of only 69 National Cancer Institute (NCI) designated centers of cancer care excellence nationwide, focuses on matching identified mutations to appropriate treatment options. "The role of an NCI center is to lead the way in discovery, and bring the most advanced cancer care to our patients. We offer a robust battery of novel therapies for patients whose tumors require aggressive treatment," says Dr. Knudsen.
"Our expanded capability to identify tumors that are addicted to specific genetic mutations is complemented by the acquisition of clinical trials that provide access to next-generation therapies. The options available for treating cancer patients have expanded tremendously, especially when you consider participation in clinical trials of the most recent targeted therapies," says W. Kevin Kelly, D.O., Professor of Medical Oncology and Director of the Solid Tumor Oncology at Jefferson. "Our new capabilities will ensure that we can deliver the best and most appropriate care for each patient."
To achieve these goals Jefferson has built a number of strategic partnerships to build on existing analytical capabilities that have been ahead of the curve in terms of national guidelines for cancer care.
Most recently, Jefferson has teamed up with Foundation Medicine, and serves as a founding member of a new Precision Medicine Exchange Consortium to provide genomic sequencing for a subset of patients with solid tumors. The collaboration gives Jefferson researchers access to patient-sequencing data as well as access to some of the most cutting edge clinical trials for targeted therapies across various cancer types.
This new consortium complements existing partnerships with a number of companies that will allow it to provide genomic guidance across the care continuum, from helping patients decide whether to take aggressive action against their cancer, or give them the confidence to wait, treatment-free. Other collaborations will combine the results from multiple types of analyses, including genomic sequencing, in order to more fully understand the biology of each patient's cancer. Some of those tests zoom out from the DNA sequence to look at changes at the chromosome level, where large-scale shifts in chromosomal arrangements cause disease. Others analyze tissue samples that are too small to be sent for sequencing but where mutations can instead be detected at the single-cell level with specific antibody staining.
"We have built the capabilities of the Genomic Pathology Laboratory with our clinicians and patients in mind," says Stephen C. Peiper, M.D., the Peter A. Herbut Professor and Chair of the department of Pathology, Anatomy and Cell Biology. "Patient biopsy samples aren't always perfect. We've made sure we can provide our doctors the information they need to treat by using an array of tools that represent the best practices for each cancer, in a format that oncologists can readily use. The unique partnerships at Jefferson amongst oncologists, pathologists, and scientists that help our researchers discover the impact of genetic alterations in cancer and culminates in the ability of the Sidney Kimmel Cancer Center to deliver such advanced and outstanding care."
"The power of these collaborations is that we will not only be able to provide patients with the best-informed care plans, but we'll also be able to use the data we collect about their disease to find and test new ideas for treatments and personalized care," says Dr. Knudsen. "This is an important step forward in our efforts to eliminate cancer, and at the Sidney Kimmel Cancer Center, our mission is to increase the pace of discovery until every cancer is cured."
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