As advancements in cancer treatment occur over time, many patients are living longer, higher quality lives with metastatic disease. The problem for patients is that there is often no standard of care for their disease, or the standard of care has proven ineffective. At some point, treatment options run out.
A program at the University of Michigan Comprehensive Cancer Center called MI-ONCOSEQ uses high-throughput gene sequencing techniques to help find new options.
The multidisciplinary project stems from laboratory work led by Arul Chinnaiyan, M.D., Ph.D., and brings together a precision medicine tumor board with expertise from clinical oncology, clinical genetics, genomic science/bioinformatics, clinical pathology, social and behavior sciences, and bioethics. It uses gene sequencing results to give clinicians and patients recommendations regarding clinical trials or targeted therapy based on the molecular characteristics of an individual patient’s cancer.
Since MI-ONCOSEQ launched three years ago, more than 400 adult patients and 80 pediatric patients have had their genes sequenced.
"Ours is one of the few pioneering studies in this area and we hope to set the standards for the future when clinical sequencing becomes adopted as routine standard of care," says Chinnaiyan, director of the Michigan Center for Translational Pathology. "We have made tremendous advances in just the short time since initiating our study and we hope to make a significant impact in the treatment of cancer that will greatly benefit patients."
In a study published in Science Translational Medicine, Chinnaiyan’s team found that identifying a patient's "mutational landscape" provides a promising approach for targeting which treatments or clinical trials may best help a patient. Researchers also use the data to identify new genetic anomalies.
Since the project began, researchers have made discoveries in both common tumors – a mutation in the estrogen receptor that makes breast cancer resistant to aromatase inhibitors – and rare tumors – a gene fusion in solitary fibrous tumor.
“Genetic sequencing is extremely important with rare tumors,” Chinnaiyan says. “Models of rare cancers to study in the laboratory are either not available or very limited. The sequencing helps us to learn more about the disease that we can use to develop better treatments or to help diagnose the cancer in others.”
Through informed consent, patients with metastatic or refractory cancer for whom standard therapies are not effective can be evaluated. For more information or to refer a patient, call M-LINE at 800-962-3555.