Precision Medicine in Oncology

While minimal residual disease (MRD) has been a topic of research for at least a decade, right now it is more top of mind than ever before for people treating cancer, said C. Ola Landgren, MD, PhD, professor of medicine and chief of the Myeloma Service at Memorial Sloan Kettering Cancer.

Caris Life Sciences, a leader in somatic testing on cancer tumor cells, has joined forces with Ambry Genetics to offer its 67-gene test that evaluates a patient’s hereditary risk for cancer.

Epigenetic drug therapy should be explored for certain patients with marginal zone lymphoma, according to a recent study.

So far, minimal residual disease (MRD) has not been used much outside of clinical trials, but researchers are testing how it might be used to guide decisions in clinical practice, said Lindsey Roeker, MD, clinical fellow at Memorial Sloan Kettering Cancer Center.

The next era in treating mantle cell lymphoma will use precision medicine to target therapies in a personalized way, said Michael Wang, MD, professor in the Department of Lymphoma and Myeloma at MD Anderson.

Nanopore technology, still in its developmental phases, could be used to detect predictive biomarkers for acute myeloid leukemia (AML), according to a recent study.

Despite a 20% drop in mortality since 2009, colorectal cancer accounted for 9.8% (881,000) of deaths worldwide in 2018 and represents 10.2% of all cancer cases worldwide. It is No. 3 on the list of most prevalent cancers worldwide—1.8 million new cases in 2018—behind only lung cancer and breast cancer.

Although the pembrolizumab 8 arm of I-SPY2 did not have strong enough results to continue onto phase 3, it does provide some insights and highlights the need for precision medicine to tailor approaches to treatment, said Rita Nanda, MD, associate professor, medicine, The University of Chicago Medicine.

Findings from 2 studies presented at the San Antonio Breast Cancer Symposium highlight the value of genomic profiling for women with breast cancer.

A study presented at the 61st American Society of Hematology (ASH) Annual Meeting and Exposition in Orlando, Florida, discussed the first report of next-generation sequencing (NGS) to test for minimal disease response (MRD) after the combination of ibrutinib plus fludarabine, cyclophosphamide, and rituximab (iFCR) in chronic lymphocytic leukemia (CLL).

The advent of next-generation sequencing (NGS) has meant better care for children with acute myeloid leukemia (AML), a better understanding of rare subtypes of genetic AML, and a better prognosis for these patients, said Sarah Tasian, MD, attending physician in the Division of Oncology at Children’s Hospital of Philadelphia.

Reimbursement for CAR-T therapy has progressed to where commercially insured patients obtain coverage regularly, but issues remain for patients with Medicare, said John Sweetenham, MD, professor in the Department of Internal Medicine at UT Southwestern Medical Center and the Associate Director for Clinical Affairs at UTSW’s Harold C. Simmons Comprehensive Cancer Center.

Here are 5 things to know about genetic testing in cancer care.

The update includes a broader, more integrated examination of other high and moderate penetrance genes associated with breast, ovarian, and pancreatic cancer.

There are a number of policy changes that can drive change within the implementation of chimeric antigen receptor T-cell therapy, but further innovation is warranted to improve access, said John Sweetenham, MD, professor in the Department of Internal Medicine at UT Southwestern Medical Center and the Associate Director for Clinical Affairs at UTSW’s Harold C. Simmons Comprehensive Cancer Center.

Tumor slices provide a useful platform for studying the tumor microenvironment and evaluating the preclinical efficacy of cancer therapeutics, according to a recent study.

Researchers in North Carolina reported discoveries that may lead to further understandings about how pancreatic cancer can become resistant to treatment.

Precision medicine may offer new hope to children with high-risk cancer, but only if families and healthcare professionals are fully educated on the benefits and limitations of precision medicine trials, according to a study in Journal of Clinical Oncology.

Genomic profiling of tumors has become standard in oncology, but tumors in children often do not have actionable DNA aberrations, requiring another way to effectively target treatment for these patients. A study in JAMA Network Open found that RNA sequencing from pediatric and young adult patients may be a feasible approach.