How close is personalised treatment?
How close are we to personalised treatment for prostate cancer, based on analysis of the genetic makeup of an individual man's cancer?
Professor Johann De Bono, Institute of Cancer Research, London and Director, London Movember Centre of Excellence:
This is a very important question. We all believe that the future of prostate cancer care is delivering more precise treatment. We already have the sequences of several hundred prostate cancers from advanced disease, and earlier stage tumours, and we’ve seen major differences in these different types of cancers - the pussycats and the tigers. Importantly, the data indicate that advanced prostate cancer is many different subtypes of disease. Indeed, some would argue that maybe one day we'll see that actually every individual patient has a slightly different cancer.
But even today, in my clinic, we are using the information from this sequencing effort to really treat each patient individually and more precisely. And we’re also running several clinical trials, and in particular, a bigger national trial, to look at this more widely. We believe this will be the first ever clinical trial to truly allow patient selection based on a subtype of prostate cancer.
Dr Gerhardt Attard, Institute of Cancer Research, London:
We are very close to achieving personalised medicine. We now have several clinical trials running designed to select men based on a specific molecular change for a specific treatment. Five years ago we used our knowledge that the androgen (male hormone) receptor remained a key driver to develop drugs like abiraterone and enzalutamide to treat advanced prostate cancer. Over the past few years our understanding of the biology of prostate cancer has increased exponentially as a result of a number of experiments based on next generation sequencing, where all the genes in tumors are studied to look for abnormalities. We now have identified gene abnormalities that occur commonly and are therefore developing both tests that will identify those abnormalities, and drugs to hit them. I believe this will improve our response rate, that is it will allow us to much more effectively treat men with both the advanced form of the disease and potentially even men with earlier stage disease, in a personalised way.
Read more about a recent publication from Dr Attard’s lab about personalised medicine.