In a major breakthrough for personalized medical treatments, researchers at the Duke University Medical Center found that "genomic predictors" can significantly foretell the likelihood of recurrences of lung cancer.
The test, developed by researchers at the Duke Institute for Genome Sciences and Policy, will help doctors provide more accurate treatment for patients.
"This is promising as an amazing alternative to the traditional hit-and-miss approach of waiting [for recurrences], and has the potential to save thousands of lives each year," said Dr. Anil Potti, an assistant professor of medicine and lead author of the study.
During the trials, researchers analyzed tumor samples from about 130 patients to identify patterns in RNA sequences among recurrent cancer hosts.
Fluorescent RNA allowed researchers to determine those genes in a tumor that are most active.
Unlike many other forms of genetic predictors, the approach largely seeks out generalized trends of cell activity rather than the presence of individual gene variants.
"We sometimes need to back up and take a broad look at things using what we know," Potti said.
"[The test] is very similar to other genomic predictors in its underlying principles, but is guided by the principle of point values to determine risk," he added.
Knowledge of which genes are most active will allow doctors to speed up treatment among patients for whom chemotherapy would not otherwise be recommended, the researchers noted in their findings, published in the Aug. 10, 2006 issue of the New England Journal of Medicine.
Researchers currently classify the risk of recurrence of the disease using "clinical stages" based on size and location-which is often broad and inaccurate, the researchers said.
Most early-stage patients with isolated tumors are treated with surgical procedures and afterwards subjected to a waiting game of tests and anticipation, during which approximately one in three "low-risk" patients will experience a recurrent-often fatal-bout with the disease, Potti said.
The researchers hope to eventually use the test to develop other forms of personalized and combined treatments for cancers, by avoiding the use of chemotherapy and other treatments among less isolated tumors, said Dr. Geoffrey Ginsburg, a professor of medicine and co-author of the study, in a statement.
"Besides hair loss, chemotherapy can cause fatigue, infections and affect the body in a number of ways that complicate the road to recovery," Potti said.
In January 2007, Duke researchers plan to begin a follow-up trial involving over 1,000 patients throughout the United States and Canada.
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