How can targeted cancer therapies improve my treatment? What is available for my type of cancer?
Targeted cancer therapies consider the genetic abnormalities causing your specific cancer and may have fewer side effects than traditional chemotherapy. Since the field is changing rapidly, your physician will know if a new treatment or clinical trial is appropriate for your individual circumstances.
Do I get a genomics test as part of my care?
Every patient at Dana-Farber/Brigham and Women’s Cancer Center and Dana-Farber/Boston Children’s Cancer and Blood Disorders Center is asked to participate in the Cancer Research Study. As part of this study, a portion of your tumor is shared with an allied research study called Profile, where the tumor will be scanned for hundreds of gene mutations linked to cancers.
What is the Cancer Research Study?
The Dana-Farber/Brigham and Women’s Cancer Center Cancer Research Study allows the use of a patient’s specimens for research studies related to cancer. Specimens are collected as part of a patient’s routine clinical care or evaluation, and may be used for a variety of research studies today or in the future. Patients’ specimens may be used for a single study or multiple studies, dependent on the evolving research needs. The ultimate objective is to better understand what causes cancer and to discover novel molecular markers relevant to the prevention, care, and treatment of cancer, which will hopefully benefit patients in the future. For more details, see the Cancer Research Study Brochure.
Is there a difference between the Cancer Research Study and Profile?
Yes, Profile is a genomics research project that is building a comprehensive database for research into the genetic makeup of different cancer types and, ultimately, into targeted treatments for individual tumors. Genotyping or “genetic profiling” scans are performed on samples of solid tumors, bone marrow, or blood specimens that have been obtained by patient consent through the Cancer Research Study. The scans may identify specific mutations and other DNA alterations that are driving a patient’s cancer. If drugs are available that target these genetic abnormalities, your physician may decide to incorporate them into your treatment plan, which could involve enrollment in a clinical trial.
How will my doctor find out if I should try a targeted treatment?
Our oncologists use many different tests to determine whether approved targeted drugs could be used in your treatment, or whether a targeted agent being tested in a clinical trial might be appropriate. In addition to the genomics test associated with the Profile project, other tests might include:
- Molecular tests of specific cancer-related genes or DNA abnormalities. These tests can be used to help doctors decide whether or not specific targeted therapies are likely to be effective. They also may be important in deciding whether a bone marrow or stem cell transplant will be the best way to treat a particular cancer, such as leukemia, lymphoma, neuroblastoma, and multiple myeloma.
- Immunohistochemical tests, which can detect the presence of too much or too little of certain proteins that play a role in cancer. These tests can offer us important information even about genes that are seemingly normal.
Where is the lab work done for these tests and who analyzes the results?
Quality control is essential in cancer testing because your treatment will be based on the result of your biopsy and other tests. Brigham and Women’s Hospital’s CLIA-certified pathology department, which handles more than 85,000 tissue samples and 7 million blood tests annually, perform the tests. Our pathology department has a strong record of experience and excellence with all tumor types, which is rather rare. Our pathologists work with the other physicians on your treatment team on diagnosis and on designing the most personalized treatment plan available, including clinical trials.
Based on results of my genomics tests, are there clinical trials that might be appropriate for me?
Your care team will know about clinical trials conducted in your disease area. If your tests reveal a gene mutation treatment that is currently under study, your physician will facilitate your participation in the appropriate trial.
Will I receive only targeted therapies?
Targeted therapies are sometimes used alone. Often, they’re more effective when combined with other treatments. It’s common for cancer to have more than one growth pathway, so multiple approaches may provide the best results.
Will my care team change if my treatment is altered as a result of genetic testing?
That is unlikely, as your care team is very involved in research associated with your cancer. From the beginning of your relationship with Dana-Farber/Brigham and Women’s Cancer Center, the members of your team include physicians who are actively studying new treatments and helping lead clinical trials of targeted therapies.