Precision Medicine in cancer therapy. How to separate hype from reality? 2
Cancer treatment continues to rely on chemotherapy. Targeted cancer drugs are selectively available for some tumors. Leading cancer expert. Precision medicine, personalized medicine, targeted cancer medications. All these words are everywhere in cancer treatment. Dr. Anton Titov, MD. Where precision medicine can help patients? Where precision medicine cannot help patients? How to separate hype from reality? Dr. Bruce Chabner, MD. Correct. That’s a big question! Precision medicine has helped us understand the biology of cancer. It has helped us define what changes are driving cancers. We know what mutations are making cancers grow. We now have cancer medications this actually block that cancer process. They’re called “targeted medicines”. That applies to a significant number of cancers that arise in the lung. Targeted therapy for skin cancers called melanoma. Targeted cancer medications for breast cancers and colon cancers. But it is still the minority of tumors. A majority of cancer patients will need treatment with oncology cancer medications. They will receive the standard kinds of chemotherapy. That have been developed over the last 40 years. Dr. Bruce Chabner, MD. My own presence in oncology. I’ve watched many cancer medications undergo testing and become valuable. They are still the backbone of treatment of many cancers. There are subsets of cancers that can be treated effectively with these targeted cancer medications. The way one finds out about that is by testing the tumor. You have to see if any of the relevant important mutations or changes are present. That would indicate you should use a targeted cancer medication here. Do not use simply the long-standing chemotherapy that’s been used in the past. Sometimes patients think about personalized medicine. Of course, cancer treatment has been personalized for patients by astute and sophisticated doctors for a long time. But it is probably the appearance of the molecular diagnostics. It is adjusting the cancer treatment to the genetics of the tumor and to the patient that has developed over the last few years. So patients should understand this. Dr. Bruce Chabner, MD. That’s correct! So this all started really about 15 to 20 years ago. There were discoveries in breast cancer and in chronic leukemia. Some important new cancer medications came forth from this research. Now it is our standard treatments for subsets of cancer patients. It is not for all leukemia patients, but subsets. It requires testing the tumor to find out if these mutations are present. Then we identify the appropriate caner cancer medication. So there are a number of instances where this strategy is actually useful. But it isn’t in all patients. Dr. Bruce Chabner, MD. As I mentioned, there are standard treatments using chemotherapy and radiation therapy. Dr. Anton Titov, MD. Of course, there is cancer surgery to remove tumors. These are still the most appropriate treatments for many patients with cancer.
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