Genomic Approach Offers Individualized Cancer Treatment

NEW YORK FEB 21, 2007 (Reuters Health) - A genomic approach to evaluating tumors can allow individualized treatment of women with advanced-stage ovarian cancer, according to a report in the February 10th Journal of Clinical Oncology.

The clinical heterogeneity of ovarian cancer contributes to the variable response to chemotherapy, the authors explain, and no single gene marker reliably predicts response to therapy and outcomes.

Dr. Johnathan M. Lancaster from H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida and colleagues coupled gene expression analysis with gene expression signatures that reflect deregulation of various oncogenic signaling pathways to identify characteristics that could guide chemotherapy in patients with platinum-resistant ovarian cancer.

The genomic-based tool accurately predicted response to platinum-based therapy in 70 of 83 tumor samples, the authors report, with an overall accuracy of 84.3%.

The gene expression model was also 78% accurate in a separate validation set, the results indicate.

The pathway signature of the tumor not only predicted deregulation of the pathway but also predicted sensitivity to therapeutic agents that target the corresponding pathway, the researchers note.

"We believe that the approach described here, using gene expression profiles that predict primary chemotherapy response coupled with expression data that identify oncogenic pathway deregulation to stratify patients to the most appropriate treatment regimen, represents an important step toward the goal of personalized cancer treatment," the authors conclude.

"We further suggest that a major benefit of this approach (and, in particular, the use of pathway information to guide the use of targeted therapeutics) is the capacity to ultimately direct the formulation of combinations of therapies (multiple drugs that target multiple pathways) based on information that details the state of activity of the pathways," the investigators add.

SOURCE:

• J Clin Oncol 2007;25:517-525.