Tailored treatment made ‘inoperable’ liver cancer vanish
IT WAS hailed as the dawn of a new era for cancer survival – ‘personalised medicine’ that helps doctors identify the drugs most likely to beat individual tumours. Now one of the first patients to benefit from such an approach, known as molecular profiling, has revealed how the breakthrough has given him new hope after he was diagnosed with inoperable liver cancer.
The procedure, details of which were announced last week, allows doctors to analyse tumour samples to determine a unique set of biomarkers – a chemical ‘fingerprint’ of that cancer. Profiling of the tumour sample, taken during a standard biopsy, can provide information about the cancer after just one or two weeks of analysis.
This can then be used to precisely match the patient’s treatment to their particular cancer, allowing scientists to offer a bespoke treatment and reducing the use of drugs that often have brutal side effects and could be of little benefit.
The technique was offered to retired company director Spartaco Dusi, 76, after he was diagnosed with liver cancer in February at a hospital near his home in Sweden.
His son Alessandro, 41, a Londonbased banker, explained: ‘Doctors there didn’t tell us his prognosis but their body language was very negative. They didn’t tell me what the treatment plan was. I felt very anxious and had a million questions. I didn’t want to take no for an answer.’
Alessandro enlisted the help of private medical advisory firm Alivia, who connected the family with Professor Justin Stebbing at the London Oncology Centre.
In February, Mr Dusi travelled to London to be treated and his biopsy results immediately underwent molecular profiling, which allowed doctors to offer him the most appropriate form of chemotherapy.
‘The results from my father’s last scan were miraculously good and showed little sign of tumour,’ said Alessandro.
Should Mr Dusi’s cancer return, the results of his molecular profiling would provide his doctors with the information to determine the best second line of treatment.
The technique was highlighted at the American Society of Clinical Oncology (ASCO) annual conference in Chicago last week in 19 clinical studies from Caris Life Sciences, a biotechnology company that specialises in precision medicine.
They looked at mutations and other biomarkers in a range of individual cancers including breast, prostrate and pancreatic cancer.
Their investigations add weight to the evidence that molecular profiling could increase survival time for cancer patients.
In a study involving more than 4,700 mixed cancer patients from across the US, there was an average increase in overall survival time of over one year for patients who underwent molecular profiling. These patients also received less therapy, suggesting that ineffective treatments were sometimes chosen for those who did not receive molecular profiling.
Prof Stebbing said: ‘The advances in molecular profiling are hugely exciting. In the past five years it has been useful for research, but we’re now at the point where it’s useful in informing real life, dayto-day clinical decisions.
‘In the old days we saw cancer as arising from an organ of origin. This is useful for a surgeon knowing where to cut. But molecular profiling allows us to look at the genes that give rise to the cancer and switch them off. It’s about treating the right patient at the right time with the right drugs.’
He believes molecular profiling, which is currently still in the trial stages and has not been given full NHS approval, is potentially useful for all cancers.
‘At the moment we already understand about some of the gene mutations responsible for some breast cancers, colorectal cancers and lung cancers but we’re going to get more and more information about other cancers as research continues.’
He added: ‘We now need randomised trials of large numbers of people in order to incorporate molecular profiling in to clinical practice as standard.’
Dr Vidar Arnulf, chief medical officer and chairman of Alivia, said: ‘We’re just at the edge of changing the complete understanding of and treatment of cancer. These latest studies provide overwhelming evidence that molecular profiling is of benefit to cancer patients.’