Download Personalised medicine briefsheet

Personalised medicine briefsheet
Personalised medicine is about matching patients with the treatment
that will work best for them. It could transform the lives of cancer
patients in the UK – that’s why, at Cancer Research UK, we’ve made
it one of our top priorities.
What do we mean by
personalised medicine?
Personalised medicine is where doctors
look at the molecular characteristics of
each patient’s cancer to work out what
treatment is most likely to benefit them.
Why do we need to personalise
cancer treatments?
No two cancers are the same. This
means that even patients with the same
type of cancer will respond differently to
treatment – not just to cancer drugs, but
often radiotherapy and surgery too.
Cancer develops when the DNA in our
cells is damaged. We have made rapid
progress in understanding the gene
faults that lead to cancer, and how they
influence the molecular landscape in
cancer cells. These molecular changes vary
from one patient to another. Next, we
need to discover how these molecular
changes affect the way a person’s cancer
responds to treatment, and develop rapid
tests to detect them.
The ultimate aim is to treat every patient
as an individual, but this vision is still some
way off.
What happens now?
At the moment, most patients with
the same cancer are given the same
treatment, even though some patients
are unlikely to benefit. This is because, at
present, doctors often have no way of
predicting who will or will not respond.
But, thanks to research and the
generosity of our supporters, we are
moving in the right direction. Doctors
and scientists are now beginning to
identify subgroups of patients with the
same type of cancer, but whose cancers
have slightly different characteristics, and
who need different treatments. Grouping
patients together like this and treating
them accordingly is known as ‘stratified
medicine’ – and it’s the first step towards
personalised medicine.
October 2010
What difference will
personalised medicine make?
A patient’s treatment is more likely to be
successful if it is tailored to their cancer.
Otherwise, patients could get treatments
that will not help.
And it’s not just at the bedside where
we expect to see benefits. This approach
should also speed up the development of
new cancer treatments by increasing the
efficiency of clinical trials that test them.
Increasingly, doctors are designing trials for
subgroups of patients who are most likely
to benefit. This makes it more likely that a
trial will produce a clear result on whether
or not a treatment is working.
Did you know?
Although personalised medicine is still
at an early stage, there are already
tailored treatments available for some
types of cancer.
Deborah’s story
‘I was diagnosed with
breast cancer in 2004
when I found a lump in
my breast whilst away
on a business trip. My
lump was large and had
spread within my breast, so I needed
to have a mastectomy to remove it.
Doctors identified my breast cancer as
HER2 positive, which meant I could be
given the drug Herceptin. I responded
really well to the drug and, thankfully,
after a long battle, I’m now in good
health again. I hope that more people in
the future will be able to benefit from
tailored treatment, as I have done.’
Cancer Research UK’s early work
underpinned the development of
Herceptin. This drug has made a real
difference for a quarter of women
whose breast cancer is likely to
respond to this treatment.
Our impact
We currently spend over £14 million
each year on research and infrastructure
that will help deliver personalised
medicine for cancer. In recent years,
we’ve made many advances that have
resulted in more tailored treatments:
•Our research paved the way for the
development of tamoxifen, which
revolutionised the treatment of breast
cancer, and later our work shaped the
use of this drug. Tamoxifen targets a
molecule on the surface of breast
cancer cells called the oestrogen
receptor. Two thirds of breast cancers
are suitable for this drug and patients
have their cancer tested before they
can be prescribed it.
•Our early lab work on a molecule
called EGFR was the springboard for
the development of the drug Tarceva
for lung cancer. Around 20-30 per cent
of lung cancer patients have faulty
levels of EGFR and could benefit
from Tarceva.
This research provided the foundations
for the development of Erbitux, which
can benefit around 6 out of 10 people
with advanced bowel cancer. Doctors
will test a cancer sample for EGFR
before starting treatment.
•Our scientists laid the groundwork
for a new generation of drugs called
PARP inhibitors that work particularly
well in breast and ovarian cancer
patients who have inherited a faulty
BRCA gene. These drugs are still in
development, and in the future, it will be important to test patients to see if
their cancer is suitable for this drug.
‘Molecular typing of
cancer is going to
become more and
more part of standard
practice for choosing
treatment. I have no
doubt that this is
going to be a huge part of
cancer medicine in the future.’
Prof Peter Johnson, Chief Clinician,
Cancer Research UK
Our progress towards
personalised medicine
Cancer Research UK is leading the way towards an era of personalised medicine. The fruits of our
groundbreaking research will save many more lives from cancer in the future and improve quality
of life for patients. None of this would be possible without the generosity of our supporters.
Our research spans many areas of
cancer – from hunting for faulty genes
and other molecular markers to
guide treatment decisions, through to
developing new targeted treatments. We
are also developing the use of the latest
technologies to monitor how patients are
responding to treatments.
Looking for markers of cancer
A key focus of our five-year strategy is to
find new biomarkers and develop tests
for them. We fund many world-leading
scientists in this field.
Biomarkers are molecules that
doctors can test for in a person’s
blood, urine, or cancer. One of the
many uses of biomarkers is to provide
a simple way to spot differences
between patients and their cancers.
They are key to making personalised
medicine possible - they are the ‘sign
posts’ that help doctors select the best
treatment for their patient.
At our Cambridge Research Institute,
Dr James Brenton and his team
are investigating why some women
with ovarian cancer respond well to
chemotherapy and others do not. They
have already found several molecules which
they hope doctors will be able to use as
biomarkers to predict who will and won’t
respond. This is just one of over a hundred
projects we fund that are geared towards
discovering new markers of cancer.
How we process drugs
Professor Roland Wolf in Dundee is
studying how differences in our genetic
make-up alter the way we process drugs.
In the same way that our genes determine
our hair and eye colour, they also affect
how our bodies break down drugs. This
is another reason why patients respond
differently to treatment.
Our genes affect how long a drug stays
in the body or how much is needed,
and in the future, this may also guide
treatment decisions.
Stratified Medicine Programme
Cancer Research UK recognises the huge
potential of personalised medicine to
revolutionise the treatment of people with
cancer. To bring this vision a step closer to
Take cancer sample
reality, we have launched our pioneering
Stratified Medicine Programme, with our
Test sample for
partners, to examine how rapid testing of
particular
molecules
cancer samples can best be rolled out
across the NHS. This type of testing is
vital if tailored treatment is to become
a routine part of cancer care, helping
Use samples
doctors to make timely decisions about
See which
for lab research
the best treatments for their patients.
treatment is
appropriate
Our programme involves taking a sample
of a person’s cancer when they are
diagnosed, and analysing it for molecular
Develop tests
changes. Scientists will use this information
to see which
patients would
Treat
to build up a picture of the different
benefit from
cancer
patterns of faults linked with specific
Was
which
treatment
patients
cancers. As other areas of research
treatment
progress and more targeted treatments
effective?
become available, doctors will be able
to prescribe the best treatment for
their patient based on this information.
Develop
Initially, the scheme will focus on collecting
more
samples from patients with bowel, breast,
tailored
lung, prostate, skin and ovarian cancer.
treatments
Making drugs more
personal
Personalised medicine isn’t just about
matching the right drug to the right patient
– it’s also about having more targeted
treatments to choose from.
We currently fund nearly 100 different
projects across the UK to discover new
cancer drugs, based on the molecules that
we know drive cancer.
International expert Professor Paul
Workman, at The Institute of Cancer
Research in Sutton, leads the largest of
our teams. They are using cutting-edge
technology to design drugs against new
molecular targets in cancer cells. Several of
the drugs they have designed are already
being tested in clinical trials with patients.
Cancer Research UK Tel: +44 (0)20 7242 0200
www.cancerresearchuk.org
Registered charity in England and Wales (1089464) and Scotland (SC041666)
Using scans to tailor treatment
As part of our five-year strategy, we are also
boosting research into imaging techniques.
These could indicate early on whether
cancer drugs are working. We have set up
four new imaging centres to drive forward
this work.
At the University of Birmingham, Dr Andrew
Peet is investigating new ways of visualising
tumours to see how they are responding
to treatment in ‘real time’. Doctors can use
this information to help choose the best
treatment option for their patients.
‘We’re still a long way
from individual treatments
for individual patients,
but new technologies
Dr
such as those in cancer
Andrew
imaging are helping to
Peet
pave the way.’