Being diagnosed with a rare and incurable cancer can leave a patient without hope.
Research is always evolving, but a majority of that focuses on major cancers that affect a majority of people. But as scientists understand more about the molecular makeup of cancer, a new weapon in previously untreatable cancers has emerged.
The genetics of a tumor can hold the key to an effective treatment. Doctors just have to know how to look for it, said Dr. Pablo Bedano, a medical oncologist at Community Cancer Center South.
“If we can find a targeted agent that works on that cancer, then the chances of side effects are much lower and the chances of success much greater,” he said. “Chemotherapy is a shotgun treatment. This is more of a smart-bomb treatment.”
In order to best treat individual patients and attack their cancers in the most effective way possible, Community Cancer Center South has convened a tumor board. The gathering brings together oncologists, molecular biologists, pharmacists and research specialists to discuss weaknesses in a patient’s unique cancer.
By focusing on the genetic and molecular makeup of the cancer, the team can use pinpoint focus to find the most up-to-date treatments possible.
“What we’re looking for is what makes the cancer tick,” Bedano said. “We can see if there is an agent that has already been approved that can block that mutation, or if it’s experimental phases to work against that mutation.”
Physicians at Community Cancer Center South have introduced molecular testing into their procedures when examining a patient’s cancer. Molecular testing breaks down the elements of a tumor at the gene level.
Working with a company in Cambridge, Massachusetts, the hospital can use next-generation sequencing to determine if there are any active mutations that are making the cancer grow.
Those results are then discussed by the tumor board, made up of Community Health Network oncologists. The local oncologists video conference with molecular biologists from Massachusetts to talk about the mutations that show up from the testing.
Pharmacists and research coordinators are also present to share information on clinical trials or new drug therapies that have shown to have success on specific tumors.
By working together, they can formulate the best treatment option for the patient’s cancer, Bedano said.
“It really helps having the input from different specialties to make a decision on treatment for the patient,” he said. “A molecular biologist may look at it from one standpoint, then a clinician might look at it a different way and the pharmacist is right there so we know if a particular drug or treatment is available. It allows us to present a better plan than if we were all working individually.”
The tumor board is another step for Community Cancer Center South as health care moves toward more personalized medicine, Bedano said.
“Everybody’s cancer is particular to them, and they may have some unique features that might help us decide what the best treatment for the cancer is,” he said.
The board meets to discuss treatment of every patient who comes to Community Cancer Center South with metastatic, or incurable, cancer. Traditional methods of chemotherapy, surgery and radiation are the best course of treatment for a vast majority of cancers, Bedano said.
But for those patients for whom traditional methods will not work, the tumor board can determine what other options exist.
“These are people who, unfortunately, their cancer has spread. The best we can hope to do is keep it under control so they can live with it as long as they can,” Bedano said. “When we come to that situation, sometimes chemotherapy can be worse than the disease. People have so many side effects from the treatment that they just don’t want to do it anymore.”
The tumor board has been meeting at Community Cancer Center South for the past year.
Though molecular testing had been used at the hospital for nearly three years, no system was in place to effectively interpret the results, Bedano said.
Now, there’s a platform to better approach that testing.
“If we’re really serious about fighting cancer, we need to have all of the data available,” Bedano said.