Forensic cancer treatment: Personalised drugs therapy becoming a reality with hopes for improvement in survival rates

 

A decade ago it took tens of millions of pounds and many years to sequence the compete genome of one individual. Now it takes a few hundred pounds and a couple of days to decode the entire DNA of a cancer cell.

The rapid pace of change in DNA sequencing is leading to a transformation in the diagnosis and treatment of cancer. In the coming decade every cancer patient will receive a genetic profile of their disease, scientists predict.

An era of personalised medicine where patients receive tailor-made treatments based on their DNA rather than their just their symptoms could end the one-drug-treats-all approach to cancer treatment, which has failed many patients in the past, they said.

The revolution will also mean that the classic method of testing new drugs and treatments based on large-scale clinical trials with thousands of patients will be replaced by a more targeted approach focussed on a smaller number of individuals with known genetic profiles.

Rapid DNA sequencing will usher in a new era of discovery where cancer drugs will be tailor-made for those patients based on the type of DNA mutations carried within their tumours, scientists said.

“In part it might signal a significant shift in the way medicine is performed for cancer in the 21st Century,” said Professor Alan Ashworth chief executive of the Institute of Cancer Research in London which has just opened a new tumour profiling unit to rapidly sequence the DNA of cancer samples.

“None of this is science fiction. It’s happening in a number of places around the world but we feel it will be absolutely routine within the next five to ten years for every cancer patient,” Professor Ashworth said.

It could mean that drugs designed for one type of cancer will be used in the treatment of a quite different cancer as scientists uncover common biochemical pathways that link one disease to another, Professor Ashworth said.

“It opens up the possibility of using drugs in a context in which they were not originally developed,” Professor Ashworth said. It could also change the whole approach to drug development and clinical trials.

Instead of having to rely on large “phase-3” trials involving several thousand patients followed for many years to determine small, statistically significant improvements, doctors could go straight to a new therapy based on their discretion, knowing that a drug can target a particular DNA abnormality, he said.

“In the past, drugs have been developed with large, phase-3 clinical trials involving thousands of patients and working out what is best for the average patient. What we are saying now is to turn this on its head – to look at what is best for the individual patient,” he said.

“It may be that in certain rare cancer types, a drug might be considered effective, even though there may well never be clinical trial evidence to prove it,” he added.

Classical clinical trials have essentially failed certain types of cancer patients, such people with tumours of the pancreas and lung, where the improvements in treatment have been minimal, Professor Ashworth said.

Similarly, some existing cancer therapies are known to be ineffective in a large number of patients who routinely receive the treatments – but DNA profiling could help to end this harmful waste, he said.

“In chemotherapy for women with breast cancer, for instance, only about one in ten receives any benefit from the treatment. So that means you are massively over-treating the population – nine out of ten receive essentially no benefit,” Professor Ashworth said.

“We want drugs that work on more patients and for longer, so let’s design the trials to deliver that and design the trials for success rather than failure,” he said.

“Basically the way we’ve been developing drugs for cancer is now failing big time. There’s not that many new drugs approved each year and certainly the idea of developing old-fashioned chemotherapies is going out of the window,” he added.

Drug resistance is one of the biggest problems to emerge from the use of new drugs targeted at certain DNA profiles. Resistance is a Darwinian process – cancer cells continue to mutate and those that are resistant survive the therapy and quickly spread around the body.

“The biggest obstacle to personalised medicine is really resistance, and understanding what causes resistance. But this is not black magic it is something that can be defined, quantified and understood, and then exploited,” Professor Ashworth said.

“Some people have taken this as a sign that personalised medicine isn’t working but the answer to that is that it’s still early days. These drugs have just been developed, we’re working out how to use them and we’re starting to understand what the resistance mechanisms are. It’s going to be much more complicated than giving a single drug and getting a cure,” he said.

Personalised medicine could actually save the NHS money in the long term if it prevents patients from developing metastatic cancers that have spread from the original site of the tumour.

“It costs about £100,000 to treat a woman with metastatic breast cancer. We can do DNA profiles for a few hundred pounds. The clinical management costs will far outweigh the diagnostic costs,” Professor Ashworth said.

“I think with early-stage disease, we will be curing more people. With advanced disease, we are talking about keeping people alive, and more importantly well, for longer” he said.

Arts and Entertainment
Sydney and Melbourne are locked in a row over giant milk crates
art
News
Kenny Ireland, pictured in 2010.
peopleActor, from House of Cards and Benidorm, was 68
News
A scene from the video shows students mock rioting
newsEnd-of-year leaver's YouTube film features staging of a playground gun massacre
Travel
travel
PROMOTED VIDEO
Voices
A family sit and enjoy a quiet train journey
voicesForcing us to overhear dull phone conversations is an offensive act, says Simon Kelner
News
i100This Instagram photo does not prove Russian army is in Ukraine
News
Morrissey pictured in 2013
people
Sport
sportVan Gaal has £500,000 video surveillance system installed to monitor Manchester United players
Environment
View from the Llanberis Track to the mountain lake Llyn
Du’r Arddu
environmentA large chunk of Mount Snowdon, in north Wales, is up for sale
Life and Style
Martha Stewart wrote an opinion column for Time magazine this week titled “Why I Love My Drone”
lifeLifestyle guru Martha Stewart reveals she has flying robot... to take photos of her farm
Arts and Entertainment
The Secret Cinema performance of Back to the Future has been cancelled again
filmReview: Sometimes the immersive experience was so good it blurred the line between fiction and reality
News
ebookA unique anthology of reporting and analysis of a crucial period of history
News
i100
Life and Style
The director of Wall-E Andrew Stanton with Angus MacLane's Lego model
gadgetsDesign made in Pixar animator’s spare time could get retail release
News
peopleGuitarist, who played with Aerosmith, Lou Reed and Alice Cooper among others, was 71
Environment
Tyred out: should fair weather cyclists have a separate slow lane?
environmentFormer Labour minister demands 'pootling lanes' for women cyclists
News
people
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

VB.Net Developer - £40k - Surrey - WANTED ASAP

£35000 - £40000 per annum + competitive: Progressive Recruitment: .Mid Level V...

Digitakl Business Analyst, Slough

£40000 - £45000 per annum + Competitive Benefits: Progressive Recruitment: Dig...

Mechanical Estimator: Nuclear Energy - Sellafield

£40000 - £50000 per annum + Car, Medical, Fuel + More!: Progressive Recruitmen...

Dynamics NAV Techno-Functional Consultant

£50000 - £60000 per annum + benefits: Progressive Recruitment: An absolutely o...

Day In a Page

Dress the Gaza situation up all you like, but the truth hurts

Robert Fisk on Gaza conflict

Dress the situation up all you like, but the truth hurts
Save the tiger: Tiger, tiger burning less brightly as numbers plummet

Tiger, tiger burning less brightly

When William Blake wrote his famous poem there were probably more than 100,000 tigers in the wild. These days they probably number around 3,200
5 News's Andy Bell retraces his grandfather's steps on the First World War battlefields

In grandfather's footsteps

5 News's political editor Andy Bell only knows his grandfather from the compelling diary he kept during WWI. But when he returned to the killing fields where Edwin Vaughan suffered so much, his ancestor came to life
Lifestyle guru Martha Stewart reveals she has flying robot ... to take photos of her farm

Martha Stewart has flying robot

The lifestyle guru used the drone to get a bird's eye view her 153-acre farm in Bedford, New York
Former Labour minister Meg Hillier has demanded 'pootling lanes' for women cyclists

Do women cyclists need 'pootling lanes'?

Simon Usborne (who's more of a hurtler) explains why winning the space race is key to happy riding
A tale of two presidents: George W Bush downs his paintbrush to pen father’s life story

A tale of two presidents

George W Bush downs his paintbrush to pen father’s life story
Restaurateur Mitch Tonks has given the Great Western Pullman dining car a makeover

The dining car makes a comeback

Restaurateur Mitch Tonks has given the Great Western Pullman dining car a makeover
Gallery rage: How are institutions tackling the discomfort of overcrowding this summer?

Gallery rage

How are institutions tackling the discomfort of overcrowding this summer?
Louis van Gaal has £500,000 video surveillance system installed to monitor Manchester United players

Eye on the prize

Louis van Gaal has £500,000 video surveillance system installed to monitor Manchester United players
Women's rugby: Tamara Taylor adds fuel to the ire in quest to land World Cup

Women's rugby

Tamara Taylor adds fuel to the ire in quest to land World Cup
Save the tiger: The day America’s love of backyard tigers led to a horrific bloodbath

The day America’s love of backyard tigers led to a horrific bloodbath

With only six per cent of the US population of these amazing big cats held in zoos, the Zanesville incident in 2011 was inevitable
Samuel Beckett's biographer reveals secrets of the writer's time as a French Resistance spy

How Samuel Beckett became a French Resistance spy

As this year's Samuel Beckett festival opens in Enniskillen, James Knowlson, recalls how the Irish writer risked his life for liberty and narrowly escaped capture by the Gestapo
We will remember them: relatives still honour those who fought in the Great War

We will remember them

Relatives still honour those who fought in the Great War
Star Wars Episode VII is being shot on film - and now Kodak is launching a last-ditch bid to keep celluloid alive

Kodak's last-ditch bid to keep celluloid alive

Director J J Abrams and a few digital refuseniks shoot movies on film. Simon Usborne wonders what the fuss is about
Once stilted and melodramatic, Hollywood is giving acting in video games a makeover

Acting in video games gets a makeover

David Crookes meets two of the genre's most popular voices