Push is on to tailor cancer care to t...

Push is on to tailor cancer care to tumor's genes

There are 7 comments on the WTOP story from Feb 16, 2009, titled Push is on to tailor cancer care to tumor's genes. In it, WTOP reports that:

The days of one-size-fits-all cancer treatment are numbered: A rush of new research is pointing the way to tailor chemotherapy and other care to what's written in your tumor's genes.

Join the discussion below, or Read more at WTOP.

“Apply directly until it hurts”

Since: May 07

San Jose, CA

#1 Feb 16, 2009
Sorry, the US can no longer afford these types of treatments. We can't have open borders and provide good healthcare for everyone. Studies have shown poorer US citizens receive more from government than they contribute. In our free-market system, it is the large, literate and productive American middle class who contribute more than they receive. And it is their productivity that raises the living standards of poor. The vast majority of illegals compete directly with our most vulnerable white, Hispanic, and African American citizens, suppressing their wages and increasing their hardship. A country's quality of life varies directly with the contribution of its population.

Peoples Abilities Varies

In Mexico only 13% of adults have a high school diploma versus 87% of American adults. PISA reading and mathematics test scores for Mexicans taught these subjects in Spanish are just as bad, if not worse, than those educated in the US. PISA officials estimate over 50% of Mexican 15-year old youth today are functionally illiterate and thus unable to compete in Mexico's economy.

http://www.worldfund.org/index.php... _and_ http://www.worldfund.org

Latin American students perform poorly on national and international tests, and even the best Latin American students tested often score only as well as the 'average' student in the most competitive economies. In fact, PISA tests have shown 2/3s of Mexican students could not consistently apply basic mathematical skills to understand an everyday situation while only about 20 percent of students in OECD countries showed similar deficiencies.

Building Human Capital - Is Latin American Education Competitive-.pdf

This has obvious ramifications for federal plans for universal healthcare. The US obviously cannot afford to provide quality healthcare to Americans while granting amnesty to illegals who have little grasp of disease prevention, unless you define healthcare as only an aspirin and a warm Coca Cola. Canada has a large immigration program and guaranteed health care for everyone, including foreigners who are legal residents. Canada does not tolerate illegal immigration. It can't afford to extend its expensive benefits to people who don't belong there.

Since: Dec 05

Irvington, NJ

#2 Feb 22, 2009
The whole concept of proper genetic markers is not to put patients in the position of having to receive toxic cancer drugs if they're not going to do any good. However, genomics is far too limited in scope to encompass the vagaries and complexities of human cancer biology.

The situation with Erbitux and Vectibix for colon cancer, Iressa and Tarceva for lung cancer, and Herceptin for breast cancer is that all the mutation or amplication studies can tell us is whether or not the cancer cells are potentially susceptible to this mechanism of attack.

They don't tell you if one drug or the other is worse or better than some other drug which may target this. The cell is a system, an integrated, interacting network of genes, proteins and other cellular constituents that produce functions.

No genetic profile can discriminate differing levels of anti-tumor activity occurring among different targeted therapy drugs. Nor can it identify situations in which it is advantageous to combine a targeted drug with other types of conventional cancer drugs.

"Targeted" drugs are poorly-predicted by measuring the ostansible "target," but can be well-predicted by measuring the effect of a drug on the function of live cells, the net effect of all processes, not just the individual molecular targets.

The benefits of newer targeted therapies are marginal. These targeted therapies may impart a clinical benefit by stabilizing tumors, rather than shrinking them (substituting shrinkage for stabilization).

I would not want to be denied treatment with any targeted therapy because of a gene mutation or amplication. Genetic testing is not a clear predictor of a lack of benefit.
Gail Perry

Spring Hill, FL

#3 Feb 22, 2009
I'm so glad you got the point, GDP.

"A bad test is as dangerous to a patient as a bad drug," notes Dr. Richard Schilsky, ASCO president and a University of Chicago oncologist.

Be careful, folks. Double check anything you've read on line before making decisions influenced by it.

Since: Dec 05

Irvington, NJ

#4 Feb 28, 2009
I know that you do not know the difference between a genetic profiling test and a cellular profiling test, Gail. I just wanted to put this out on the post.

Sequencing the genome of cancer cells is explicitly based upon the assumption that the pathways - network of genes - of tumor cells can be known in sufficient detail to control cancer. Each cancer cell can be different and the cancer cells that are present change and evolve with time.

It was thought that if billions of dollars were poured into genotyping by DNA sequencing of primary tumor would find the critical mutations that cause cancer and then make drugs to them so that each patient can have a unique treatment.

The major problem with this is the primary tumor is so heterogeneous that each cell within it is likely to have a unique genomic signature at the level of mutations, as well as at the level of gross genomic imbalances and methylation signatures.

And the cells that will be dangerous to the health of the patient and depart to other organs make up only a minute fraction of the tumor. They are also genomically different to the cells in the primary tumor.

Today, we have the ability to take a cancer specimen, analyze it, and follow those genetic changes that influence particular pathways, then use two, three, four or more targeted therapies, perhaps simultaneously, and be able to completely interrupt the flow of the cancer process.

A number of cell-based assay labs across the country have data from tens of thousands of fresh human tumor specimens, representing virtually all types of human solid and hematologic neoplasms. They have the database necessary to define sensitivity and resistance for virtually all of the currently available drugs in virtually all types of human solid and hematologic neoplasms.
Gail Perry

Spring Hill, FL

#5 Mar 2, 2009
GDP, you don't know the difference between imagining things researchers actually said and providing verifiable cites.

When you are ready to back up your extravagant claims with verifiable cites (and your unsupported posture as an expert)-- do let us know.

Meanwhile, folks, be very careful. Just because something sounds credible online doesn't mean it's true. If you're really dealing with these medical issues and it's not just a game to you, double-check anything you read online with your doctor.

Since: Dec 05

Irvington, NJ

#6 Mar 2, 2009
Hundreds of thousands of cancer patients cannot wait for your "flat earth" society Gail.
Gail Perry

Spring Hill, FL

#7 Mar 3, 2009
GDP, I'm one of those hundreds of thousands. I could lose my life acting on your gross overinterpretation of the things you've read.

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