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By ASTARA MARCH
WASHINGTON, Oct. 7 (UPI) -- The recent discovery in Sweden of a group of 64 genes that can be used to predict whether women with breast cancer will respond to treatment following surgery moves the infant field of DNA microarray analysis closer to viability as a clinical tool.
After more testing and commercial development, the assay for the new gene cohort will supplement two already existing products called MammoPrint, developed by Agendia in Amersterdam, Netherlands, and Oncotype DX, by Genomic Health Inc. in Redwood City, Calif. MammoPrint searches for a 71-gene group associated with the tumor's risk of recurrence, and Oncotype DX identifies a 21-gene cohort that determines whether the tumor in question will respond better to chemotherapy or hormonal therapy.
Scientists hope to use DNA microarray analyses and two other tests -- chemotherapy sensitivity/resistance assays that identify which drugs affect the tumor, and pharmacogenomic testing that determines how the patient's body will respond to the toxicities each drug produces -- to create treatment plans that fit the tumor and the patient like a glove.
Experts told United Press International the tests should be inexpensive enough to be performed on every breast-cancer patient.
Dr. Christi Iacobuzio-Donahue, assistant professor of oncology and pathology and a researcher on genetic microarrays at Johns Hopkins Medical Center in Baltimore, said a focused array that targets a specific gene group eventually should cost only about $100, and the other two assays should be equally reasonable.
"Gene expression studies are not looking at all 33,000 human genes anymore," Iacobuzio-Donahue said. "Focusing on specific groups is moving the technology into a cost-effective era."
Researchers had different ideas on what would bring genetic testing to the bedside more quickly.
Dr. Anthony Elias, medical director of the Breast Cancer Research Program at the University of Colorado in Boulder, and Dr. Larry Norton, deputy physician-in-chief of breast cancer programs at Memorial Sloan-Kettering Cancer Institute in New York City, said changing genetic assays so they could be performed on the paraffin-embedded tissue specimens -- which commonly are used in pathology labs instead of fresh frozen specimens that need special equipment -- would enable the technology to be used at the community-hospital level, instead of being confined to comprehensive cancer centers and teaching hospitals.
Dr. John Olson, associate professor of surgery and breast cancer specialist at Duke University Medical Center in Durham, N.C., said physicians hesitate to use the tests, because they were developed using cancer patients who had been treated in the past, not tested in clinical trials of using current patients.
Norton said he thought such trials were an excellent idea, but worried the means to mount them might not be available.
"As the ideas explode, the opportunities to do the work are shrinking," he said. "The field is suffering from a lack of funds and the small number of adult patients who are willing to participate in clinical trials."
These experts agreed genetic testing and individualized therapy would be the preferred treatments of the future, and probably could become a reality in five to 10 years.
"Personalized medicine is our dream," Elias concluded. "Trials like this (one in Sweden) get us one step closer."
Astara March covers healthcare technology for UPI. E-mail: [email protected]
For those too lazy/unable to access link:
By ASTARA MARCH
WASHINGTON, Oct. 7 (UPI) -- The recent discovery in Sweden of a group of 64 genes that can be used to predict whether women with breast cancer will respond to treatment following surgery moves the infant field of DNA microarray analysis closer to viability as a clinical tool.
After more testing and commercial development, the assay for the new gene cohort will supplement two already existing products called MammoPrint, developed by Agendia in Amersterdam, Netherlands, and Oncotype DX, by Genomic Health Inc. in Redwood City, Calif. MammoPrint searches for a 71-gene group associated with the tumor's risk of recurrence, and Oncotype DX identifies a 21-gene cohort that determines whether the tumor in question will respond better to chemotherapy or hormonal therapy.
Scientists hope to use DNA microarray analyses and two other tests -- chemotherapy sensitivity/resistance assays that identify which drugs affect the tumor, and pharmacogenomic testing that determines how the patient's body will respond to the toxicities each drug produces -- to create treatment plans that fit the tumor and the patient like a glove.
Experts told United Press International the tests should be inexpensive enough to be performed on every breast-cancer patient.
Dr. Christi Iacobuzio-Donahue, assistant professor of oncology and pathology and a researcher on genetic microarrays at Johns Hopkins Medical Center in Baltimore, said a focused array that targets a specific gene group eventually should cost only about $100, and the other two assays should be equally reasonable.
"Gene expression studies are not looking at all 33,000 human genes anymore," Iacobuzio-Donahue said. "Focusing on specific groups is moving the technology into a cost-effective era."
Researchers had different ideas on what would bring genetic testing to the bedside more quickly.
Dr. Anthony Elias, medical director of the Breast Cancer Research Program at the University of Colorado in Boulder, and Dr. Larry Norton, deputy physician-in-chief of breast cancer programs at Memorial Sloan-Kettering Cancer Institute in New York City, said changing genetic assays so they could be performed on the paraffin-embedded tissue specimens -- which commonly are used in pathology labs instead of fresh frozen specimens that need special equipment -- would enable the technology to be used at the community-hospital level, instead of being confined to comprehensive cancer centers and teaching hospitals.
Dr. John Olson, associate professor of surgery and breast cancer specialist at Duke University Medical Center in Durham, N.C., said physicians hesitate to use the tests, because they were developed using cancer patients who had been treated in the past, not tested in clinical trials of using current patients.
Norton said he thought such trials were an excellent idea, but worried the means to mount them might not be available.
"As the ideas explode, the opportunities to do the work are shrinking," he said. "The field is suffering from a lack of funds and the small number of adult patients who are willing to participate in clinical trials."
These experts agreed genetic testing and individualized therapy would be the preferred treatments of the future, and probably could become a reality in five to 10 years.
"Personalized medicine is our dream," Elias concluded. "Trials like this (one in Sweden) get us one step closer."
Astara March covers healthcare technology for UPI. E-mail: [email protected]