MI-ONCOSEQ is an exciting new initiative at MCTP to exploit the rapid advances in DNA sequencing technologies to realize the goals of “personalized medicine” for the treatment of cancer. Personalized medicine involves the identification of the specific molecular/genetic lesion(s) that is responsible for disease progression and “targeting” that lesion(s) with a drug specific for it.  A famous example is the BCR-ABL gene fusion (the shuffling and subsequent joining together of two separate genes in the genome causes “gene fusions” that can be an important cancer causing mechanism) that gives rise to the blood cancer, chronic myeloid leukemia (CML). The most exciting aspect of this story is that CML patients can be treated with the drug called imatanib that inhibits a critical activity of one of the genes in the fusion pair.  This paradigm of “actionable” molecular target linked to an effective drug represents one of the major successes of personalized medicine in cancer treatment.  Before the advent of imatanib therapy CML patients generally died of their disease. 

Unfortunately unlike CML, there are multiple sub-sets of cancer-driving gene fusions in prostate (and other solid) cancer and indeed we have identified several different gene fusions -as well as other types of genetic aberrations- in patient samples. The implications for this are that there will not be a “one size fits all” therapy and treatment must be “personalized” to target the specific aberration. Additionally, some cancers will be indolent or slow-growing whereas others will be aggressive, metastatic disease. Therefore, it will be important to properly identify those that will require aggressive treatment from those that will not. The ultimate goal would be to identify the specific “actionable” driving mutation in individual cancer patients so that effective and appropriate treatment plans can be pursued.  

Identification of specific disease mutations in the laboratory was once a painstaking task, often requiring previous knowledge of the nature of the mutation and only one or few mutations could be interrogated at a time. However, because of recent exponential advances in DNA sequencing technologies in the last few years, as well as reduction in costs, it is now possible to scan the entire genome of cancer patients at once; and combining DNA sequence data with powerful computational biology and bioinformatics tools, we can nominate driving mutations in an unbiased manner.

MI-ONCOSEQ project brings together expertise at the University of Michigan including clinical oncology, clinical genetics, genomic science/bioinformatics, clinical pathology, social and behavioral sciences, and bioethics in order to implement the practice of personalized medicine in cancer treatment. This project will also address some of the major ethical challenges that accompany genetic testing.

To learn more about MI-ONCOSEQ project or how to participate in the study, please discuss with your treating physician/oncologist first and have them contact our study coordinators.