Ask the Expert: Personalized Care - What You Need to Know
Watch Dr. Edward Kim discuss the what you need to know about lung cancer targeted therapies and personalized medicine.
Dr. Edward Kim: In general terms, personalized medicine uses information about a patient's cancer as well as his or her age and overall health in order to better diagnose and treat their disease. In the past, the type of information we could find out about a person's cancer was not as detailed as it is now.
Traditional treatments for cancer, including lung cancer have involved giving patients chemotherapy. Cancer cells, which grow and divide in an out of control way, that's how they eventually form tumors. Chemotherapy stops these cells from growing and dividing and tries to kill them. One of the problems with this is that pretty much all of the cells in our bodies grow and divide, so chemotherapy affects all the cells in the body, not just the particular cancer cells. Chemotherapy often has side effects like hair loss or stomach sickness and vomiting.
Over the past 10 years or so, we have learned that cancer cells have unique features that show us why the cells become cancerous. We are learning more about these traits, what we call molecular biomarkers, that are unique to each person's tumor. We are also developing drugs that will find these molecular biomarkers and kill those cancer cells that have them. This kind of treatment is called targeted therapy because these drugs target the cancer cells, they usually harm fewer healthy cells in the body than traditional chemotherapy.
Molecular biomarkers can be either genetic material or proteins. They determine what the cell is, how it acts, and even how it will respond to any given treatment. Fortunately, we now have tests that allow us to find and measure the presence of these molecular biomarkers in the cells of a specific lung cancer tumor in a specific person. If a patient has these molecular biomarkers, there are drugs that can be used to target their cancer cells in particular. We expect to see more and more drugs like these in the future.
Personalized therapy really starts with testing the tumor. We'll ask for certain biomarkers specific to lung cancer to be tested. Two of the more common ones are EGFR, which stands for epidermal growth factor receptor, and ALK, A-L-K. Now, for the majority of patients who don't have the presence of either of these particular markers, we will use chemotherapy. What has evolved also with chemotherapy is that we are using specific chemotherapies in certain types of lung cancer.
I take all of the information about the patient's lung cancer type, stage, and tumor profile based on biomarker testing, as well as his or her age and overall health. I then discuss my recommendations for treatment. We work together to make the best treatment decision for each individual patient based on their own personal goals. With the current clinical trials that I'm involved in, we are on the verge of many very important discoveries. As we head into the future and build on these discoveries, we will have more good options for treating patients with lung cancer using a personalized medicine approach.
Approved by Scientific and Medical Editorial Review Panel. Last reviewed November 24, 2017.