MD Anderson Set To Moon Shot Cancer

[KDR]

http://www.mdanderson.org/newsroom/news-releases/2012/ut-md-anderson-cancer-center-launches-unprecedented-moon-shots-program.html

The first announcement I heard on this indicated there would be eight cancers targeted.

Karen

[michka]

It's about time to bring all researchers together..
Only triple negative breast cancers? There are not enough women dying of breast cancer to be on the list (and more and more of young women)?
One of the criteria is "the potential for near-term measurable success in terms of cancer mortality". What does this mean? They think they have weapons, they think it is desperate or the list was made up by only men? I am wondering.

[Pray]

Go MD Anderson!

[gdpawel]

Great technology, but information of extremely limited value. People will think because they are being completely genotyped, this will give all the answers needed. But it won't. Genotyping will only be of value for drugs for which a gene mutation is informative -- basically KRAS and EGFR mutations -- and we already have tests for those and they are of very limited value. Otherwise, it's a ton of information for which the drug selection value is pretty useless.

What's more important than what genes are in the DNA is what genes are actively making RNA, which RNA is actively making protein, which protein is being turned off or turned on, and how all of the proteins in the cell are interacting with each other. The only way to get the latter information, which is ultimately what you want, is to treat the patient with phenotype analysis. In drug selection, phenotype analysis doesn't dismiss DNA testing, it uses all the information, measuring the interaction of the entire genome, to design the best treatment for each individual.

I believe this and other recent announcements have been overreached and giving us overexpectations. The research is exciting, but the path remains long and arduous.

Dr. Len Lichtenfeld of the American Cancer Society wrote:

“It is important to recall that despite the fact this is incredibly sophisticated and difficult work, it is still reasonably early in our ability to perform the analyses, interpret the data, and determine the best way to apply it to the clinic. We still have a long way to go, and we must always remember that cancer has a way of being more complicated at every turn that we might otherwise anticipate as our research and our knowledge advances. But research such as this also puts more of the pieces of the puzzle of breast cancer together in a way that a solution to the dilemma of understanding breast cancer and how we can apply the best treatment does appear to be more readily at hand.

What is the most important message from this research?

Unfortunately, it is not going to change lives immediately. Your doctor isn’t going to give you a different treatment for your breast cancer today, tomorrow, or next week because of this research. There is no question that doctors involved in breast cancer treatment are going to take a very careful look at this research and determine the best way to apply this information to new approaches to breast cancer as quickly as they can, but that will still take time.

To me, the most important message from this research is to confirm what many of us have been thinking for some time now: we are seeing the fruits of decades—yes, decades—of hard work in the laboratory taking us to a point we are going to have a significant impact on patient care and the outcomes of treatment for cancer. At the same time, the very support for that research is in jeopardy due to decreases in government funding, business investment, and private philanthropy.”

http://acspressroom.wordpress.com/2012/09/24/naturebreastcancertypes2012/

[gdpawel]

http://www.healthnewsreview.org/2012/09/cnn-proclaims-breaking-news-cure-for-cancer-close/

[SoCalGal]

This does not sound like the goal is to cure - sounds very TREATMENT based, even if the treatment is improved!
http://cancermoonshots.org/moon-shots/breast-ovarian/


Increase the five-year survival rate of women with triple-negative breast cancer or high-grade serous ovarian cancer
Identify women and families at risk for these cancers and implement programs to decrease the chance they will develop cancer
Change the upfront treatment to improve the outcomes of women with these cancers
Within the first year, implement clinical trials of promising new therapies
Develop new imaging technologies that can detect aggressive lethal breast tumors at an early stage
Convert temporary responses to durable therapy by identifying and targeting drug resistance mechanisms

[gdpawel]

The "Moon Shots Program" will focus on genomics to understand the genetic and molecular basis of cancers and to identify patient-specific treatments by making genomics routine in cancer care. Tumor analysis coupled with clinical trial literature search to try and match therapies to patient-specific biomarker information to generate a treatment approach. The problem is that genomics cannot predict for disease or patient-specific drug effects (drug selection).

No technology is more well suited to the investigation and simultaneous analysis of the relationships between patient-specific target molecules, cell functions and cell sub-populations than cytometry and Cytometric analysis of cell phenotype and function provides a very comprehensive overview of this ever-broadening field. It doesn't dismiss DNA testing, it uses all the information, measuring the interaction of the entire genome, to design the best treatment for each individual.

Replacing the one-size-fits-all paradigm with another one-size-fits-all paradigm isn't making personalized cancer therapy any more cost effective. Targeted therapy is still a one-size-fits-all model. Finding what targeted therapies would work for what cancers is very difficult. A lot of trial-and-error goes along trying to find out.

Molecular profiling measures the expression of protein only in the "resting" state, prior to drug exposure. There is no single gene whose expression accurately predicts clinical outcome. Efforts to administer targeted therapies in randomly selected candidates often result in low response rates at significant toxicity and cost.

Molecular profiling is based on the same clinical literature search (population study), which tries to match therapies to patient-specific biomarker information to generate a treatment approach. This is not really personalized medicine, but just a refinement of statistical data. In other words, information that may help when considering "potential" treatment options (theoretical analysis). It's never even measured against your actual cancer cells.

All the molecular profiling studies tell us is whether or not the cancer cells are potentially susceptible to a mechanism of attack. They don't tell you if one drug is better or worse than another drug which may target a certain mechanism. The cell is a system, an integrated, interacting network of genes, proteins and other cellular constituents that produce functions. You need to analyze the systems' response to drug treatment, not just one mechanism of attack.

None of the targeted drugs are cures, they are life savers by being a life lengthener. Targeted therapy is what is used to stabilize the disease rather than cure it. Will patients have to take the drugs indefinitely? How is that cost effective?

Most targeted drugs do not directly kill cancer cells, they just stop the growth of tumors. Therefore, patients must receive treatment for prolonged periods, and over time, they often develop secondary resistance. They eventually succumb to treatment resistance or disease recurrence.

To beat down individual cancer mortality, an oncologist needs to target all the many cancers that make up individual cancer, the dozens of different mechanisms that cells use to proliferate and spread. That is the leading edge of personalized research and treatment, determining how an individual's tumor cells work and hitting those pathways with multiple drugs, simultaneously or sequentially, each chosen because it targets one of those growth, replication and angiogenesis mechanisms.

Trying to mate a notoriously heterogeneous disease into one-size-fits-all treatments is disingenuous to all who are inflicted with it. And the criticism remains: All of the clinical trial resources have gone toward driving a square peg (one-size-fits-all chemotherapy) into a round hole (notoriously heterogeneous disease).

[gdpawel]

http://www.medscape.com/viewarticle/772706

In an apparent effort to play King Solomon, the University of Texas System vice chancellor for health affairs has granted a limited waiver from the institution’s conflict-of-interest policy to the president of the University of Texas MD Anderson Cancer Center, The Houston Chronicle reports.

And the move is prompting criticism because because the cancer center president Ronald DePinho will be allowed to maintain financial ties with his three drugmakers. His holdings in Aveo Pharmaceuticals, Karyopharm and Metamark Genetics will be placed in a blind trust as part of the waiver, the paper writes.

This is clearly an interesting and unusual situation. The vice chancellor appears to be suggesting that real-world experience is useful to the school and apparently does not want to make a move that might prompte DePinho to exit. On the other hand, the critics make a point that a partial waiver suggests a slippery slope.

Source: Pharmalot

http://www.chron.com/news/houston-texas/houston/article/UT-System-lets-MD-Anderson-president-keep-3976008.php