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New cancer test could prove key

A new means of testing cancer cells for genetic mutations at Norwalk Hospital could revolutionize the way the disease is treated.

“This is a huge deal,” said Dr. Richard Frank, director of cancer research at the hospital. “We hope it’s the future of cancer treatment.”

Researchers at the hospital’s Whittingham Cancer Center have entered into an agreement with Foundation Medicine of Cambridge, Mass., to offer individualized tumor DNA testing for patients with cancer.

The company uses a pioneering technique called next-generation sequencing to analyze hundreds of cancer-related genes on small amounts of cancer tissue. This genomic analysis will reveal which genes in a cancer specimen are altered, or mutated. With this information, doctors may prescribe drugs that target those specific mutations, even if they are normally not used for that particular cancer.

For example, a sample of lung cancer could show the same genetic mutation as a sample of breast cancer and therefore might be susceptible to a drug used more commonly for breast cancer and not for lung cancer.

It has been known for years that cancer is driven by changes in a cell’s DNA when they reproduce out of control, but the specifics of those mutations have been unknown until now. The Foundation Medicine test will analyze hundreds of genes at one time, far more than doctors are able to analyze without the test.

Research study

The genomic profile test — which would normally cost around $5,000 — will be offered to some patients for free in the context of a research study.

“This will enable us to understand how to best use the information to help patients with difficult-to-cure cancers, beginning with lung cancer,” said Dr. Frank.

Standard chemotherapy treatment is not cancer-specific, he said. New drugs being created in the laboratory target specific molecules in a cancer cell. Examples include Herceptin® for the treatment of breast cancer, Rituxan® for the treatment of lymphoma and Gleevec® for the treatment of CML (chronic myelogenous leukemia).

“Those drugs have revolutionized cancer treatment,” Dr. Frank said.

How the test works

When a patient is selected for the study, a sample of the tumor is sent to Foundation Medicine for analysis. After testing, which takes two to three weeks, the doctor receives a printout describing the mutations and a list of both approved and unapproved drugs that target those mutations.

“We are doing this for people with few options left,” after having tried the standard therapies that are available, Dr. Frank said. “We are looking to see what we can do that’s out of the box.”

With the test information in hand, a patient’s doctor can perhaps prescribe a drug that targets the changes in their tumor or steer them to a clinical trial that is testing a drug targeted to their condition.

Drug trials that target a specific population have the highest chance of successful outcomes, Dr. Frank said. Those that are non-specific, taking all comers, can have dismal success rates.

“A lot of new trials are aimed at molecular defects regardless of cancer type,” Dr. Frank said. “The new cancer therapies are coming from chemists designing (drugs) to go after specific cancers,” he said.

For this test at Norwalk Hospital, the focus will be on lung cancer, Dr. Frank said, because of the great need. “A lot of lung cancers are uncurable,” he said. “There are a lot of molecular changes, a lot of targeted pills available, and a large population of patients.”

The test is also available to patients suffering other types of cancer, but it would be at their personal expense unless covered by insurance.

Dr. Frank expects the test period to last about two years and involve about 50 patients.

“We will report the results and if patients did better than those without the test,” he said. “Everyone in oncology hopes this is the future.”

Norwalk Hospital is involved in a number of clinical trials and drug studies. For more information, call Jennifer Long, APRN at 203-852-2996 or email jennifer.long@norwalkhealth.org.

For information about Foundation Medicine, visit foundationmedicine.com.

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