°µĶųTV Langoneās Center for Molecular Oncology Profiles Each Patientās Cancer, Aiding in a More Precise Diagnosis & Optimal Therapy
Dr. Shridar Ganesan, the inaugural director of the Center for Molecular Oncology, and Dr. Alec Kimmelman, director of Perlmutter Cancer Center, plan to provide serial liquid biopsies for every patient diagnosed with cancer. These biopsies will help define each cancer and match it to available therapies or clinical trials.
Credit: Joe Carrotta
Cancer researchers have traditionally classified tumors primarily by location: lung, breast, prostate, colon, and so on. But Shridar Ganesan, MD, PhD, an expert in cancer biology and DNA repair, notes more recent evidence has shown that sorting based on anatomy is not the most effective approach. āSaying ālung cancerā is kind of like saying āpneumonia,ā in that itās not specific enough,ā explains Dr. Ganesan. Just as there are many types of pneumonia, and their treatment approach varies depending upon the specific infection causing it, lung cancer is actually a large collection of diseases. Researchers have come to realize that optimal cancer treatment often depends upon a tumorās unique traits, such as its acquired genetic mutations, rather than its location. The key is to identify the altered genes, proteins, and other molecules that may be driving a tumorās development and progression. āThis is a fundamental change in how we classify our diseases, understand their biology, and break them down from organ-based syndromes into specific diseases for which we have specific treatments,ā says Dr. Ganesan. Since joining °µĶųTV Langone Health in October as inaugural director of the Center for Molecular Oncology at °µĶųTV Langoneās Laura and Isaac Perlmutter Cancer Center, he has been working to put an ambitious new classification system into practice.
The Draw
The institutionās depth of expertise in basic biology, genomics, and clinical research, as well as its infrastructure, were primary factors in Dr. Ganesanās decision to join °µĶųTV Langone from Rutgers Cancer Institute. In his new role, he leads the push toward providing an unprecedented level of personalized cancer care. Collecting and overlaying information on each patientās unique disease could help answer critical questions: What mutations are driving a cancer? When is it likely to return? How is it evolving during treatment? Where are its weak points? The goal is to scale up the new service and ensure that it is available to every patient. āWeāll have this expertise at all 11 of our sites across the enterprise, regardless of where patients enter the system,ā says Alec Kimmelman, MD, PhD, director of Perlmutter Cancer Center.
The Approach
As part of the new standard of care, the center will provide to every patient serial liquid biopsies, blood tests that allow the DNA of cancer cells to be sequenced at different time points. āRight now, comprehensive molecular characterization of tumors tends to be used to help guide treatments only after everything else has failed,ā Dr. Ganesan says. With the new systemās phase-in slated to begin this year, each cancerās molecular profile will be part of the up-front diagnosis and classification. By integrating that profile with findings from pathology, histology, radiology, and other medical data, clinicians can drill down into key features, such as a tumorās behavior and its response to therapy. Clarifying the basic biology of each cancer provides an in-depth profile of its traits and weaknesses that can help doctors diagnosis it earlier, monitor for relapse or recurrence, match it to available therapies or clinical trials, and help researchers develop new interventions.
The News
With Dr. Ganesanās arrival, °µĶųTV Langone is now recruiting a leader to expand the cancer data hub within Perlmutter Cancer Center. āWeāre going to have a lot of information that needs to be integrated and utilized for diagnostics, other clinical purposes, and research,ā Dr. Kimmelman says. āThat means building up both the computing and the personnel infrastructure.ā It also means developing in-house molecular tests that are more sensitive and specific. New data points like mutations and mechanisms of drug resistance could inform and inspire further research. Ultimately, the team hopes to develop a rapid response program for patients with a cancer diagnosis. āWe envision a patient coming in and, within a day, having their tumor biopsied, having the pathological and molecular diagnosis, and if a target is found, leaving with a medication optimal for their specific disease,ā Dr. Kimmelman says. āWeāre really taking this to the next level.
