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Translating Targeted Cancer Therapies into the Patient Setting

November 02, 2009 | Jill O'Donnell-Tormey, Ph.D.

Nausea, vomiting, and hair loss are just a few of the cancer treatment side effects that all cancer patients dread. These unwanted effects come from the non-specific destruction of fast dividing cells, which is not only a hallmark of cancer cells, but also exhibited by hair follicles and the cells that line the GI tract. I think all cancer patients would herald the development of therapies that are more specific to their particular cancer and therefore less destructive to the normal cells of their body.

Newer, targeted therapies aim to destroy only cancer cells by homing in on cancer-specific cellular pathways or markers that do not appear in normal cells. To date, however, targeted therapies have not been a panacea for cancer patients. We have come to learn that only a subset of patients seem to posses the pathway or marker for which these therapies are targeted. Therefore, it is important to make sure that a patient has the right kind of cancer and associated markers to benefit from a targeted therapy.

I was dismayed to read in a recent published report in the journal Cancer that one such therapy, Herceptin, may not always be given to the right patients. Herceptin only works in women with HER-2 positive breast cancers, about twenty percent of all breast cancer patients. Results of this recent study found that up to two thirds of patients with aggressive breast cancer had no documentation in insurance records of having the genetic test done that would determine if their tumors were HER-2 positive. This suggests that many women who could benefit from the drug are not receiving it and some women might well be getting the drug with no hope that it would be effective. Clearly, this is not the best scenario.

As we move closer and closer to personalized medicine and scientists increase their focus on identifying new biomarkers that will enable us to determine which treatments will be most effective in which patient population, we need to address how this cutting edge knowledge gets translated into practice. Healthcare delivery is beyond the mission of the Cancer Research Institute, but as an organization that has helped to fund the biomedical research that has led to the explosion of knowledge poised to revolutionize cancer therapy, it is a serious concern. We can't afford to waste this innovation.

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