05 October 2012

Faster cancer treatment with genome superhighway

A new supercomputer-based network will allow doctors to use genomic sequencing to speed cancer treatment and could increase survival chances for patients.


A new supercomputer-based network will allow doctors to use genomic sequencing to speed cancer treatment and could increase survival chances for patients, its creator, billionaire healthcare businessman Dr Patrick Soon-Shiong said.

A group of technology and healthcare companies have formed the superhighway that will accelerate the time for genetic analysis of a patient's tumour to 47 seconds from eight to 10 weeks now, Soon-Shiong said.

The idea of matching a cancer to the most effective treatment, by determining the tumour’s DNA profile, has been a dream for more than a decade. Some experts remain sceptical, however, that faster information will save lives.

How it works

Under the network, oncologists compare treatment options based on genetics, risk, and cost before they begin treatment, according to the statement from NantWorks, which is owned by Soon-Shiong.

The network allows oncologists to evaluate the cancer's molecular pathways earlier in the treatment process, which could increase survival over the usual current practise of choosing a treatment based on what organ - breast or lung, for instance - the tumour started in, the statement said.

Groups involved in the project to provide include health insurer Blue Shield of California and companies such as Verizon and Intel Corp., according to NantHealth, part of Soon-Shiong's company.

The network connects to over 8 000 practising oncologists and nurses, the release said.

‘Life-saving information’

More and more companies are now springing up to perform this kind of DNA analysis. Foundation Medicine, based in Cambridge, Massachusetts, for instance, offers a $5 800 test that probes a tumour sample for more than 200 genetic alterations known to occur in cancers and gives doctors a report suggesting both approved and experimental drugs.

Personal Genome Diagnostics Inc., based in Baltimore, Maryland, does such testing as well. Such "personalised cancer treatments" have scored some qualified successes. But they generally fall far short of cures.

Pfizer's Xalkori, for instance, targets a mutation called ALK found in a few percent of non-small-cell lung cancers. It had been thought that disabling what seemed to be the cancer-causing mutation would be a home run. In fact, the drug extends the time when a patient's cancer does not progress from an average of three months with standard chemotherapy to 7.7 months.

Similarly, Roche's Zelboraf, which targets a mutation called BRAF in some advanced melanomas, extends survival from an average of 9.6 months with standard chemotherapy to 13.2 months.

"The tumour goes away for a while but it doesn't stay away forever," said an expert at the David H. Koch Institute for Integrative Cancer Research at MIT in Cambridge, Mass. For that reason, NantHealth's claim that speeding information about a patient's tumour DNA to doctors will provide "life-saving information" seems dubious, said this source, who asked not to be identified in order to speak freely: "It seems pretty much a delusion."

Other experts took issue with NantHealth's claim that many cancer patients are not given the therapy that has the best chance of targeting their cancer-causing mutation, and that by speeding genetic information to a physician in 47 seconds patients will be saved.

"It's completely wrong to say that patients are being harmed because genomic analyses are too slow," said cancer surgeon and cancer genetics expert Dr Michael Mann of the University of California, San Francisco. "You can get these tests back in a week, which is plenty of time for expeditious patient care. It's misleading to imply that increasing the speed at which information becomes available to a clinician will improve outcomes for cancer patients."

The greatest barrier to improving outcomes is not more genetic data, which cancer scientists and physicians are already deluged with, said Mann, but making sense of it: "We don't know what to do with the information we already generate" about tumours’ genetic profiles.

Blue Shield of California emphasised not the tumour genetics part of the collaboration with NantHealth but the advanced technology system. The high-speed data links and other elements will allow physicians "to proactively identify opportunities for intervention before problems occur," the company said in a statement.

(Reuters Health, October 2012)

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