It is time to bring cancer genomics from the lab bench into large-scale clinical trials, a leading Cancer Research UK scientist will tell delegates at the charity's Senior Researchers Meeting in Harrogate today.
Professor Patrick Johnston is one of a number of pioneering scientists exploring how intimate genetic knowledge from individual tumours could help doctors predict which treatments will benefit their patients best. Major trials of this approach – which has shown considerable success in the lab – are needed to test its full predictive potential.
Progress towards this goal has been too slow to date, according to Professor Johnston. He believes that large-scale trials could lead to a paradigm shift in the way doctors approach treating their patients, as well as providing new medical facilities to enable this complex but potentially revolutionary area of research to reach cancer patients across the UK.
Tumours are often resistant to individual chemotherapy drugs. Identifying patients who are not likely to benefit from a particular treatment would enable doctors to pursue other lines of treatment – freeing patients of the side effects of drugs that are unlikely to help them and improving their chances of survival.
Genomics allows scientists to obtain the detailed genetic 'fingerprints' of tumours. These fingerprints group tumours into specific types with much greater accuracy than is possible using traditional features such as tumour size, location and cellular make-up – and make it possible to predict which type of treatment will be most potent against them.
Professor Johnston, who is Director of the Centre for Cancer Research at Queens University Belfast and Belfast City Hospital, says: "Cancer genomics could really change the way doctors treat cancer.
"But turning that hope into reality will require a bold acceleration in clinical research. Using genomics in treating cancer is new, and potentially very expensive. Clinical trials will tell scientists and doctors how accurately the use of genomics can target treatments to patients, and confirm whether it is safe and cost-effective.
"Clinical trials for cancer are still very much focussed on testing new drugs. We believe an integrated approach to treatment using detailed genetic information about tumours and patients needs to become a priority."
One barrier to targeting treatment in this way is the risk of false negatives – meaning that patients could be selected not to receive a drug that they actually needed.
Dr Richard Sullivan, Cancer Research UK's Head of Clinical Programmes, says: "Cancer doctors know that many of the drugs they use will only benefit some patients – but they have no clear way of knowing which ones.
"Well-run clinical trials integrating genetic technologies could lead to predictive tests to make treatment a more exact science.