K I Woo
Feb 11, 2016
In the near future as the price of mapping human genomes continues dropping, serious diseases such as cancer will be targeted at earlier-and-earlier stages and melted away with target designer drugs.
In his recent best seller, The Industries of the Future, author Alec Ross said traditional invasive cancer therapies such as chemotherapy will have a very limited role.
Comprehensive disease genomic models
Ross explains how Lukas Wartman, a 33 year-old Washington University, St Louis oncologist and researcher survived three bouts of acute lymphoblastic leukemia (ALL) when his colleagues at the University’s genomic institute decided to do sequence both his deoxyribonucleic acid (DNA) and ribomucleic acid (RNA).
Using the university’s 26 sequencing machines and supercomputer, they painstakingly compared Wartman’s healthy DNA cells with his leukemia cells.
After several weeks, the sequencing machines and super computers found the culprit. One of Wartman’s genes was producing large quantities of FLT3, a protein that ultimately spurred his cancer growth.
The scientists prescribed a recently produced Pfizer drug, Sucent that was intended for kidney cancer. Within two weeks, Wartman was in remission.
Intensive gene sequencing saved his life.
Damaged DNA and cancers
Ross said all cancers begin with DNA that becomes damaged through time, by inherited genetic make-up or by environment factors such as cigarette smoke.
Mutated DNA and RNA which generally work together to make proteins begin to malfunction and either fail to control growth of unhealthy cells (creating tumors) or fail in their role as the body’s repair engine and allow cells to become cancerous.
Scientists use genetic sequencing to identify whether the protein is malfunctioning because the DNA is providing bad genetic programming or if RNAs role in creating protein is not working.
By sequencing Wartman’s healthy and cancerous genes and RNA they can pin-point where the breakdown occurred.
Earlier and earlier cancer detection
As sequencing costs rapidly decrease, Ross said commercialization and private investment will create new diagnostics, therapies and drugs around genetics.
Bert Vogelstein, a Johns Hopkins oncology and pathology professor and noted cancer and genomics expert proved in the 1980s that DNA mutations turn into cancer.
“Since then 15 genes have been identified as key actors behind the development and the spread of cancer.”
Volgelstein concentrated his efforts on detecting cancer earlier-and earlier before they become incurable.
Liquid biopsy
Volgelstein and his colleagues latest effort is a “liquid biopsy” that involves taking blood samples and testing for the tiniest amounts of tumor DNA.
This technique uncovers tumors that are one per cent of the size detected by conventional MRIs. The tumors are so small that the cancer can be discovered before any symptoms develop.
Vogelstein’s goal is detecting cancers before they pose a mortal threat.
Commercialization
In 2009, Vogelstein and a Johns Hopkins colleague Luis Diaz founded Personal Genome Diagnostics (PGDx) that now offers sequencing similar to what Lukas Wartman received.
Under the PGDx process, when a person is diagnosed with cancer, his oncologist sends in a tumor sample and a spit vial. The cancer and normal cells are compared.
Once PGDx receives the samples, it begins the painstaking genome sequencing process. When the sequencing is done, gigabytes of information are crunched and analyzed.
Although any genome company can undertake a similar process, Ross said PGDx has a proprietary computer program, developed at Johns Hopkins that acts as a high speed detective.
The program parses out what proteins are mutating.
When things go right, PGDx can determine why a person has cancer and what medications can stop the mutations.
Future landscape
In the future, Ross said traditional chemotherapy will have a very limited role in cancer treatments because targeted gene therapies will be used.
Developing drugs targeted to an individual’s genetics as opposed to using chemotherapy, the author said is as unsubtle a change as the introduction of anesthesia in the 19th century.
“It will make today’s most cutting-edge treatments look absolutely primitive by comparison.”
