The Human Genome Project was a really big deal, identifying the genes that make up our body. And quantum leaps in computing power, added to scientific discoveries, have been helping cancer specialists identify subtypes of disease, enabling drug developers to come up with ever more targeted therapies. More and more of these medicines for ever more narrow genetic subtypes of cancer are starting to blossom with the Food and Drug Administration anointing some with "breakthrough" status and the promise of quicker approvals.

Major academic medical centers are now performing genetic analysis on the blood or biopsied tissue of new cancer patients. Dr. Colin Pritchard, a pathologist, in a recent Patient Power interview did a great job explaining what they do at the University of Washington and the Seattle Cancer Care Alliance. Sometimes it takes weeks, but now pathologists have more detective tools to tease out which genes may be damaged in a given cancer patient. Then they try to match that knowledge with a medicine, or combinations of medicines, that are available as approved therapy or through a clinical trial. As Dr. Pritchard explained, sometimes the genetic, molecular testing reveals unexpected results. In other words, without that knowledge a patient might have received a less effective or ineffective therapy, and suffered the side effects that go with them needlessly. Testing is being used now in some types of leukemia, melanoma, lung cancer and sarcoma, among others.

Dr. Colin Pritchard Dr. Colin Pritchard

Molecular testing is not yet refined for many cancers. For example, in the myeloproliferative conditions (MPNs), such as myelofibrosis, it is still very much a research project. In chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML) it's more accepted and common. In myeloma we are not there yet. But the connection between genetic, molecular analysis and therapy is closing fast. My advice to a new patient is to strongly request such an analysis of their cancer situation and to inquire whether there are therapies, even in clinical trials, that line up with their specific genetic situation.

Researchers are very excited about delivering "precision medicine" across all cancers. Some types are more advanced, but it is coming across the board with incredible speed. The cost for analysis is coming down and the number of available targeted medicines is going up. Make sure you or your loved one gets the treatment that is most "precise."

Wishing you and your family the best of health!