Best explanation: 10 subgroup of Breast cancer by gene/RNA

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jenrio
jenrio Member Posts: 558
edited June 2014 in Clinical Trials, Research News, Podcasts, and Study Results

Best layman explanation, don't miss side bars:

http://www.bbc.co.uk/news/health-17740690

 http://scienceblog.cancerresearchuk.org/2012/04/18/increasing-the-resolution-on-breast-cancer-the-metabric-study/

Quote: "Crucially, each of these (2000) tumour samples is linked to detailed information about the subsequent fate of the women they were from. And, just as crucially, a large number of the samples are linked to a ‘matched normal’ sample (in other words, a sample of non-tumour DNA from the same patient)."

Also has a description and prognosis of 10 clusters.  

Original at nature.com:

http://www.nature.com/nature/journal/vaop/ncurrent/full/nature10983.html 

Ideally, future clinical trials should be designed with less population but better selection.   Approval process should be accelarated more.   More patients should volunteer for earlier stage clinical trials, since each clinical trial may have more difficulty accruing different subtype of patients.  Donation of tumor samples may help, as in this case, 2000 samples were analyzed.   This was unthinkable even 10 years ago, but in another 10 years will be cheap and very accessible

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  • cp418
    cp418 Member Posts: 7,079
    edited April 2012

    http://www.cbsnews.com/8301-504763_162-57415982-10391704/study-breast-cancer-not-one-disease-but-10-distinct-diseases/

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  • Momine
    Momine Member Posts: 7,859
    edited April 2012

    Very interesting, thanks for posting.

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  • Sommer43
    Sommer43 Member Posts: 600
    edited April 2012

    This broke on yesterday's news here in the UK. 

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited April 2012

    This topic is fully developed in Eric Topol, MD's new book, The Creative Destruction of Medicine.  He said that further genetic testing of tumors and other diseases will lead to more targeted and preventative therapies.  Furthermore he mentions that in the future,  clinical trials will no longer be population based.  They will be more individualized and take the guess work out of who will respond better to one therapy over another.  This will save money and fewer lives will be lost.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited April 2012

    This is a big incentive for women to join clinical trials.

    To get free whole genome sequencing tests performed and the very best treatment you will

    have to join a clinical trial, so as to determine which of the 10 BC subtypes you have

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  • cfdr
    cfdr Member Posts: 549
    edited April 2012

    Anyone know how this is different from the Oncotype DX? I thought that also looked at the genetics of the tumors.

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  • jenrio
    jenrio Member Posts: 558
    edited April 2012

    good question: Oncotype DX tells you 4 pieces of information:   HER2, ER, PR, and a recurrence score, which is computed out of about 13 gene expressions through an algorithm.   The algorithm is tested from about 600 samples.

    This new study is tested from 2000 samples, looks at more genes and find the 10 clusters of how the genes went wrong.    This information can be the basis for more future targetting of magic bullets.   Think of how Herceptin is the magic bullet for Her2+ women and how gleevac is the magic bullet for certain sarcomas and how Xalkori is the magic bullet fo a very small minority of lung cancer patient.

    It's not the beginning of the end, but it's the end of beginning.   To classify the beasts, to name the beasts and to vanquish the beasts.   I'd look for where the tumor samples can be donated for more research and more clinical trials should be requiring tumor samples.

     

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  • luv_gardening
    luv_gardening Member Posts: 1,393
    edited April 2012

    The big question for me or anyone who has finished initial treatments, is whether they can retrospectively look at our tumour samples if they are held in storage and still testable, so that when the appropriate genetic treatments are found, we can get that treatment before there's a chance for progression. 

    Does anyone know if tumour samples are kept long term?  If not, maybe pathologists should make some provision for future analysis. Otherwise this will only benefit new patients after they start routine testing for the genetic variations, or those with mets that can be tested.

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  • jenrio
    jenrio Member Posts: 558
    edited April 2012

    Many hospitals in the US hold tumor samples for 10 years.   And a lot of gene tests can be run on these samples.   There are tests that can be covered by insurance

    http://www.foundationmedicine.com/ 

    they test for about 80 common cancer /treatment genes (not just breast cancer treatment genes) .   So drugs like xykori which targets ALK (80+% clinical response in lung cancer), can potentially be used in minority of breast cancer patients.    

    If your insurance don't cover it or you don't need your tumor sample any more or you have plenty, you should consider donating your patient record and  your tumor sample to researcher.  So they  get more data to work from.     If this research has any implication, it's more data, better analysis.  Eventually better targetting.

    I'm looking for researchers that collects tumor samples and patient record and run genetic tests on them?

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  • luv_gardening
    luv_gardening Member Posts: 1,393
    edited April 2012

    Thanks Jenrio, Hopefully they do the same thing in Australia.  I don't see my MO for 6 months so it's a long time to wait to find out.

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  • elimar86861
    elimar86861 Member Posts: 7,416
    edited April 2012

    Ten subgroups?  Wow.  Now add that to the discovery that a single tumor can have cells of two or more types, and how many permutations are out there?   The targeted therapy may need to be aimed at several targets, not just one.  

    http://www.nejm.org/doi/full/10.1056/NEJMoa1113205

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  • otter
    otter Member Posts: 6,099
    edited April 2012

    Good point, elimar -- and, it's a moving target.  Not only are tumor cells unexpectedly heterogeneous, but those cancer cells can change which genes they're expressing and the genes themselves can mutate.

    So, sure...   base a woman's treatment on her tumor's particular genetic (molecular) profile.  But let's be sure it's not last month's profile that's being used, okay?  That would be like treating a bacterial infection with the antibiotics that would have been effective against the infection a month ago, but aren't going to work today because the bugs have developed antimicrobial resistance since then.

    otter

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited April 2012

    Programs like MIT's bio engineering department are so important because they are finding faster and cheaper ways to decode the tumors' genetics. I know I sound like a broken record... But Eric Topol, MD, discusses this in his book The Creative Destruction of Medicine.

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