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Technologist Mark Byrne of the Center for Advanced Molecular Diagnostics works with the Sequenom instrument for OncoMap. Photo by Sam Ogden, Dana-Farber Cancer Institute.
The research effort in cancer genomics launched this month by Dana-Farber Cancer Institute and BWH stands out for its inclusiveness, in the number of patients who will be invited to participate and the amount of data to be collected.
While other cancer hospitals and research centers have programs that scan certain tumors for a small number of gene mutations in some patients, the study at DFCI and BWH is currently open to all adult cancer patients treated at the two hospitals’ Longwood campus. Soon, it will be open to pediatric patients at the Jimmy Fund Clinic and Children’s Hospital Boston and adult cancer patients at Faulkner Hospital. Patients who agree to participate will have their tumor tissue tested for nearly 500 cancer mutations in 41 genes.
Because it is entirely a research project, the study will not affect the treatment that most patients currently receive. Its goal is to advance scientific knowledge about cancer and generate leads for the development of better, more personalized therapies in the future.
“To draw meaningful results in this kind of research, it’s necessary to collect data in large amounts,” said Dana-Farber Chief Scientific Officer Barrett Rollins, MD, PhD, one of the architects of the plan. “Opening the study to so many patients is critical to understanding the genetics of cancer, and to tailoring future therapies to the mutations in individual tumors.”
The decision to gather information from as many patients as possible reflects the enormous diversity of cancer at the genetic level. Tumors that look and act alike may carry a different set of mutations. Those variations influence how tumors grow, spread and respond to treatment. Capturing that complexity and making it accessible to scientific analyses requires prodigious stores of data.
“By inviting every patient to participate, we’ll have the opportunity to build a database adequate to the size of the genetic puzzle that cancer represents,” Rollins said.
Patients will have the opportunity to enroll in the study when they register for treatment, either at Dana-Farber’s Central Registration area or the Weiner Center for Preoperative Evaluation at BWH.
Tumor tissue that has already been obtained for clinical purposes will be tested for mutations using the OncoMap system developed by Dana-Farber’s Levi Garraway, MD, PhD. The testing will be done in BWH’s Center for Advanced Molecular Diagnostics Laboratory. Newly developed information systems will make the data available to scientists at DFCI and BWH for a wide range of research projects.
Partners in genomics
Ambitious in scope, the study wouldn’t have come about without intense collaboration between DFCI and BWH.
“This program has been a partnership from the start,” said Janina Longtine, MD, BWH’s director of Molecular Diagnostics. “A project this ambitious requires not only the resources and expertise of both institutions, but also a willingness to discover how these capabilities best mesh with one another.”
For nearly two years, teams of physicians, laboratory scientists, translational researchers (who bridge the realms of laboratory and clinical science), information technology experts, administrators and clinical service providers from both hospitals worked to assemble and implement the program, tackling everything from patient access issues, to financing, to procedures for preparing and analyzing tumor tissue.
The result, as the study gears up and begins enrolling patients this month, is a program intended to make a major contribution to personalized medicine.