
Push on to tailor cancer care
Rush of research pointing the way
WASHINGTON - The days of one-size-fits-all cancer treatment are numbered: A rush of new research is pointing the way to tailor chemotherapy and other care to what's written in your tumor's genes.
Everyone with advanced colon cancer now is supposed to get a genetic test before taking two of the leading treatments. It's a major change adopted by oncologists last month after studies found that those pricey drugs, Erbitux and Vectibix, won't work in 40 percent of patients.
Scientists are furiously testing similar genetically tailored care in breast and lung cancer. The flurry of work reflects a huge problem: Most medications today benefit at best about half of patients, but it usually takes trial-and-error to tell.
That means a lot of people suffer side effects for nothing, and it is incredibly costly. When the American Society of Clinical Oncology recommended giving colon cancer patients that $300 test for a gene called KRAS, it estimated the move could save a stunning $600 million a year - by keeping drugs that cost up to $10,000 a month away from patients who would not benefit.
As tantalizing as this personalized medicine is, gene testing is like the Wild West. Laboratories often introduce new tests at the first clues they might work. Few tests so far have won the backing of major medical groups, making research studies a best bet for many patients.
This is not about testing if people carry cancer genes that make them prone to illness. Instead it's about finding a tumor's genetic signature - a pattern of gene and protein activity that signals if the cancer will grow fast or slowly, be more or less likely to recur, and whether it would be susceptible to treatment.
"We're getting into science fiction sort of, if now medicine is being able to analyze things at the genome level," breast cancer patient Claire Weinberg of Oxford, N.C., said.
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