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Personalised medicine

Why we use biomarker profiles in planning each complex patient’s case-management

General experience supported by the results of some studies indicate that after initial treatment fails, many cancers will not respond to the next treatment when decisions are based only using conventional methods.

Biomarkers provide unique clues about each patient’s cancer, and where these biomarkers are properly validated—which treatments are more likely to be effective, and just as importantly, which therapies are more likely to fail. We are now entering an era where,  with focused genetic and molecular information about their patient’s distinct disease, oncologists can develop personalized treatment strategies designed for maximum effectiveness. Research in biomarkers and their relevance to cancer therapies is changing how we approach the characterization and treatment of cancers, and importantly where no other treatments are available, biomarkers may assist in decision-making in cancer medicine.

This approach depends on careful selection of biomarkers that are predictive for individual drug outcomes, as part of an overall medical management system called a “Multidisciplinary Team Meeting” or MDT, where these personalised data are considered within the overall context of the patient history and priot treatment, investigations, radiology and pathology review.

Using properly quality controlled platforms with our molecular testing partners, multiple technologies comprising immunohistochemistry, (IHC) fluorescent in situ hybridisation (FISH), qRT-PCR (quantitative reverse transcribed polymerase chain reaction) and ‘deep sequencing’ (mutation testing) of many cancer cell genes and proteins can be evaluated in order to be discussed in our multi-disciplinary team meeting.

With a rapid turn-round time, the reports include interpretation of the profile results and an estimate the strength of the evidence based on published literature for all the chosen biomarkers. Subsequently within the context of the medical consultation, these data can be discussed in context in the overall plan for the patient.