Case Histories Reveal Practical Power of Cancer Genomics

The article linked below clearly indicates the potential benefit of gene sequencing of cancer patients.  That knowing someone's genetic make-up is important to cancer patients. 

I put an article on the peoplebeatingcancer site yesterday explaining how curcumin alters human gene expression. 

Therefore, genetic expression is a key determinant for cancer survivors and genetic expression can be altered. 

http://peoplebeatingcancer.org/article/curcumin-helps-change-gene-function-combat-cancer

Case Histories Reveal Practical Power of Cancer Genomics-

The impact of genomic data on the management of cancer patients is illustrated in 2 case histories reported in the April 20 issue of the Journal of the American Medical Association...

In each case, the patient presented with an unusual history and whole-genome sequencing was carried out...

Although whole-genome sequencing remains expensive and requires an infrastructure that is incompatible with a clinical setting, the trends being reported suggest that "we are a lot closer to cost-effective, clinical genomics than most physicians realize," they write...

The patient whose management was changed is reported by John Welch, MD, PhD, and colleagues from Washington University in St. Louis, Missouri. The patient, a 39-year-old woman with acute myeloid leukemia (AML) in first remission, had been referred for possible allogenic stem cell transplantation.

However, the AML was of an unclear subtype, and different subtypes of this cancer are treated in different ways. Her clinical presentation suggested acute promyelocytic leukemia (APL), which has a favorable prognosis and is treated with retinoic acid, but cytogenetic analysis suggested another subtype, which has a poor prognosis and is treated with bone marrow transplantation.

Whole-genome sequencing was carried out to "resolve the therapeutic conundrum," the editorialists explain...

The critical decision in the treatment of AML, and of acute lymphoblastic leukemia, comes at about 6 to 8 weeks after presentation. Initial treatment is with remission-induction chemotherapy, but after that, a decision must be made about whether to go for consolidation chemotherapy or allogenic transplantation, they explain.

"The ability to generate comprehensive genomic data in a time frame that is clinically relevant for a patient is a remarkable achievement," the editorialists explain...

In the second case, reported by Daniel Link, MD, also from Washington University, and colleagues, the information from the whole-genome sequencing did not help the patient personally, but is now being used to counsel her family.

This patient was suspected of having a cancer susceptibility syndrome because of a personal history of primary tumors of early onset, even though there was no family history of cancer. She developed breast cancer at 37 years of age, which was treated with surgery, local radiation, and chemotherapy, and developed ovarian cancer at 39 years of age, which was treated with surgery and chemotherapy. The ovarian cancer recurred when she was 42 years, and she was again treated with chemotherapy. Six months later, she presented with treatment-related AML, developed respiratory failure, and died 8 days after presentation.

Because of the history of early-onset breast and ovarian cancer, the patient was tested for BRCA1 and BRCA2 mutations using commercial tests, but the results were negative...

hese 2 cases of personalized genomic medicine are just the first examples of what "will likely be commonplace in the future," say the editorialists.

The speed of data collection is increasing and the cost of this technology is decreasing. Both are estimated to change by another order of magnitude in the next 2 years, and changes in the way cancer is characterized will come rapidly, the editorialists predict."

To read the entire article-

http://www.medscape.com/viewarticle/741692?src=mpnews&spon=7

Does anyone have experience with gene sequencing?

thanks

David Emerson