RIGHT TREATMENT, RIGHT PATIENT RIGHT TIME!
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1 RIGHT TREATMENT, RIGHT PATIENT RIGHT TIME! Richard Kennedy MB BSc PhD FRCP McClay Professor in Medical Oncology Queen s University r.kennedy@qub.ac.uk
2 Centre for Cancer Research & Cell Biology Outline Genes and Cancer Ovarian Cancer Breast Cancer
3 What s a gene? 30,000 Instructions in DNA - Genes
4 Alterations in the DNA Instructions = Mutations
5 Cancer Involves Multiple Gene Mutations Heat oven to 180C. Put 200g flour, 8 tablespoon cocoa powder, 2 teaspoon baking powder, 1 teaspoon bicarbonate of soda, 280g light brown soft sugar in a bowl. Heat oven to 180C. Put 200g flour, 8 tablespoon cocoa powder, 2 teaspoon baking powder, 1 teaspoon bicarbonate of soda, 280g light brown soft sugar in a bowl. Heat oven to 180C. Put 200g flour, 8 tablespoon cocoa powder, 2 teaspoon baking powder, 1 teaspoon bicarbonate of soda, 280g light brown soft sugar in a bowl.
6 The Problem Cancer is a complicated disease with many genetic abnormalities. Cancers arising from the same anatomical site can be very different between patients. - at least 10 types of breast cancer - at least 5 types of colon cancer Traditionally most cancer therapies are given as a one size fits all.
7 The Solution : Personalize Treatment Using Biomarkers Biomarker: something you measure to predict how a disease will behave with treatment
8 How do you Find A Biomarker?
9
10 Sorting by genomics Carboplatin Paclitaxel Trial No treatment Different Disease
11 Centre for Cancer Research & Cell Biology Outline Genes and Cancer Ovarian Cancer Breast Cancer
12 Ovarian Cancer 225,000 new cases of ovarian cancer worldwide in 2008, accounting for around 4% of all cancers diagnosed in women Believed to arise from fallopian tubes Usually has spread at diagnosis Treatment is surgery with paclitaxel and carboplatin chemotherapy (for over 15 years)
13 13 Ovarian Cancer Programme three main objectives: 1. Identify the different types of high grade serous epithelial ovarian cancer using genetic analysis 2. Work out what makes them different 3. Find therapies that work for specific types
14 Research CCRCB/Almac Analysed 287 high grade serous ovarian cancer samples with Edinburgh University Identified the different types
15 15 Gene Expression Analysis Identified Three Types of High Grade Serous Ovarian Cancer
16 16 Gene Expression Analysis Identified Three Types of High Grade Serous Ovarian Cancer Angiogenic Ovarian cancer
17 Centre for Cancer Research & Cell Biology Angiogenesis Cancer needs to make its own blood supply to grow.
18 Centre for Cancer Research & Cell Biology ALM201 QUB and Almac scientists have developed a new drug that destroys blood vessels in cancer (ALM201) Al m 201 Al m 201 Al m 201
19 19Gene Expression Analysis Identified Three Types of High Grade Serous Ovarian Cancer Test for Angiogenic Ovarian cancer
20 Centre for Cancer Research & Cell Biology ALM201 study Phase I First relapse ovarian cancer Angiogenesis test Positive Negative ALM201 Standard therapy Radiological Response Progression free survival Richard Wilson: ECMC Belfast
21 Centre for Cancer Research & Cell Biology Outline Genes and Cancer Ovarian Cancer Breast Cancer
22 Centre for Cancer Research & Cell Biology Breast Cancer Test Although chemotherapy can help cure breast cancer not all patients benefit. Almac collaborated with CCRCB to analyze over 400 breast cancer samples to better understand the disease. Have developed a test that can personalize chemotherapy on an individual basis.
23 Centre for Cancer Research & Cell Biology DDRD Test Predicts Benefit from DNA Damaging Chemotherapy Chemotherapy No Chemotherapy Health Economic analysis has shown the test to be cost saving
24 Centre for Cancer Research & Cell Biology Clinical Use of The DDRD Test Patient has Surgery to Remove Breast Cancer Pathologist Diagnoses Early Cancer Apply DDRD Test Positive Negative DNA-damaging Chemotherapy Other Chemotherapy
25 Centre for Cancer Research & Cell Biology SUMMARY Understanding how the DNA recipe changes will help us choose the -Right Treatment -Right Person -Right Time May lead to new treatments through a better understanding of ovarian and breast cancer
26
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