is a clinical sequencing approach that exploits the rapid advances in DNA sequencing technologies to realize the goals of “precision medicine”
for the treatment of cancer. Precision 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 cancer-driving aberrations and pathways that are both unique and common across various cancer types and indeed individual patients. 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 identify informative and/or actionable molecular aberrations in an individual's tumor that may inform potential therapeutic options that may otherwise not be considered.
MI-ONCOSEQ brings together expertise at the University of
Michigan including clinical oncology, cancer genetics, genomic
science/bioinformatics, and clinical pathology in order to implement the practice of precision cancer medicine.
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.