In precision or personalized medicine, we move beyond what’s true for big groups of patients to see what information we can use to help an individual patient.
Precision medicine bridges the laboratory and clinic, often with targets for treatment identified from laboratory exploration of the inner workings of the pancreatic cancer cell being matched to available drugs that hit these targets. There is much back and forth as clinicians and scientists work together to identify cancer’s vulnerabilities and develop therapies that exploit them.
The Path to Precision
Decades of research and advanced technologies have gotten us to this point. They provide a new vantage point that affords scientists the ability to isolate and explore all components of cancer cells and the supporting cast of cells—the genetic hardware and the chemical software—to uncover the culprits that drive pancreatic cancers and expose vulnerabilities that can inform new treatments. These drivers include gene mutations or physical changes to the instruction manual that tell cells how to behave, epigenetic alterations or chemical changes to the DNA that also alter cell behavior, cancer’s ability to evade the immune system and the immune system’s willingness to tolerate cancer, and an entire microsociety around tumors that can cause cancer-inciting inflammation or help provide nutrients and other products essential to cancer cell survival. Each of these guides the treatment plan and is the basis of precision medicine approaches.
“We are tailoring what we do based on the biology of the tumor, but there is much more to this than technology and information. It’s also our multispecialty collaboration that allows us to move beyond simply accumulating information to using it wisely to make a difference for patients,” says Zheng. “We have the expertise to understand what things are actually driving the cancer so that we can match available drugs to actionable targets. This is essential because attacking a target that is not influencing a cancer is not of much use and can actually be damaging.”