Genomic test decides which drug is best for cancers

Scientists at Duke University, North Carolina have developed a panel of tests which are able to analyze a cancerous tumor and then decide which chemotherapy will most efficiently attack the cancer.

In a study the researchers assessed the tests' ability to predict how patients with breast and ovarian cancer and leukemia responded to various anticancer drugs and found that the tests predicted the clinical response to chemotherapy with 80 percent accuracy.

The revolutionary test will be trialled in 120 breast cancer patients next year and will compare how well patients respond to the chemotherapy selected by the gene test versus the chemotherapy chosen by doctors in the usual way.

Dr. Anil Potti who was the lead researcher says the test could save lives and reduce patients' exposure to the toxic side effects of chemotherapy drugs and could be applied to all chemotherapy-treated cancers.

He says with the tailored treatment doctors will be able to personalise chemotherapy in a way that should improve outcomes, but chemotherapy is likely to remain the backbone of many anti-cancer strategies.

The test scans thousands of genes from a patient's tumour to produce a "genomic" profile of the cancer's molecular makeup and by using the test on cancer cells in the lab, the scientists were able to match the right chemotherapy for the patient's type of the tumour.

When they checked these selections by observing how the patients responded to the drugs in real life, the scientists discovered the predictions were correct more than eight times out of 10.

Doctors presently use a trial-and-error approach to chemotherapy, trying various established drugs to see which has an effect and as a result, patients often undergo multiple toxic therapies in a process that places patients' lives at risk as their conditions worsen with each treatment.

Joseph Nevins, Ph.D., the study's senior investigator and a professor of genetics at the Duke Institute for Genome Sciences & Policy, says over 400,000 patients in the United States are treated with chemotherapy each year, without a firm basis for which drug they receive; they believe the genomic tests have the potential to revolutionize cancer care by identifying the right drug for each individual patient.

The study was funded by the National Institutes of Health and is published in the November 2006 issue of the journal Nature Medicine.