New hopes for personalised cancer treatment

The Tumour Profiling Unit run by The Institute of Cancer Research (ICR) in Chelsea will use state-of-the-art techniques such as genome sequencing, epigenetics and imaging to identify a patient’s cancer at the start of diagnosis then track the cancer as it progresses, mutates and develops resistance to drugs throughout a patient’s course of treatment, writes our science reporter Asha Tanna.

In the next five to ten years tumour molecular profiling for cancer therapies should be “absolute routine practice” for every patient.

The comment from ICR’s chief executive Alan Ashworth, professor of molecular biology went on: “Every cancer is different to every patient. But they are built from the same principles that they have to do certain things to clarify them as a cancer.

“Our understanding of the biology of cancer is advancing and genome sequencing has revolutionised the way we do science. Through personalised therapy not only can we tailor it to the individual, but the treatment of that patient can be adjusted as the genetic profile of their tumour changes.”

It took a decade of work and around £2 bn to produce the first draft of the human genome, or genetic code, in 2000. Today a person’s genome can be sequenced in a day or two for as little as £3,000.

Let’s design the trials for success rather than failure. Alan Ashworth, professor of molecular biology

The team also aims to develop “liquid biopsies” that search for free-floating cancer DNA in blood samples which hope to identify cancer sub-types.

Dr Nick Turner clinical researcher at the ICR said: “Repeated biopsy is difficult for patients. Cancer releases cells into the circulation. By analysing the cancer DNA in blood it is similar to carrying out a biopsy but it is done in real time because it is from a blood sample.

“Resistance in cancer is inevitable. Which patients respond to drugs and which don’t is difficult to predict. In some cases it may be suitable to give patients “drug holidays”, where they are taken off drugs for a while and then perhaps put back on different drugs. Bu using combined therapies we can monitor drug resistance before deciding what treatment is suitable.”

The attitude that one therapy fits all is changing rapidly in oncology. Professor Ashworth added: “We need to identify subgroups that have a proportionately larger benefit, say 25 per cent, which means that you intrinsically need many fewer patients.”

“Let’s design the trials for success rather than failure. Basically the way we’re developing drugs for cancer is now failing big time. Certainly, the idea of developing old-fashioned chemotherapy is going out the window.”