It might sound strange, but cancers are actually unique to every individual. Just like fingerprints, they appear to be similar, though, on closer inspection, they differ widely.
In 2006, at the age of 46, Teresa McKeown was diagnosed with breast cancer. She followed the standard treatment and overcame the malignancy. 11 years later though, it came back in full force, with what is called triple-negative disease, more aggressive and harder to treat. Nothing worked this time. It quickly spread to her intestine, making it difficult to eat and causing her peritoneal cavity to fill with liquid. Now Teresa had lost all hope and began writing goodbye letters to her children.
In this darkest of moments, one shimmer of light appeared in the form of a clinical trial at Moores Cancer Center at UC San Diego Health. Following a test designed to reveal the genetic abnormalities found in tumors, she was able to qualify for an experimental drug called Opdivo. Part of a new generation of immunotherapies, the treatment started turning the tide and within weeks scans showed no trace of cancer.
By doing a comprehensive tumor profiling, doctors are able to determine genetic mutations or other abnormalities in the DNA of the cancerous cells and possibly recommend unusual solutions, like using melanoma therapy for breast cancer. These targeted therapies can significantly improve patient outcome and have become the focus of many pharmaceutical companies.
Many drugs from this category can actually extend their effectiveness to other forms of cancer. For example, Keytruda, approved by the FDA in 2014 for the treatment of advanced melanoma, was later expanded to include patients suffering from tumors that carry a genetic mutation called microsatellite instability-high or MSI-H. This was the first case where a drug was sanctioned based on the genetic characteristics of the disease, rather than the cancer’s location.
While something similar did exist, checking for BRAF mutations in melanoma and ROS1, ALKr, EGFR in lung cancer, the comprehensive tumor profiling techniques offers a more detailed picture and can often suggest a better course of action.
Medicare does help in some cases, but the tests can be quite expensive and don’t always find an FDA approved treatment for each situation. Even though this worked for Teresa, it doesn’t mean it can help everyone, at least at this moment.