Collaborating to Fight Cancer

Genome sequencing is changing our basic understanding of cancer, necessitating changes in clinical practice and collaboration across specialties.

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Today we’re in an era of understanding the genetic causes of cancer.

We used to classify cancers based on where they arose in the body and what they looked like under a microscope. Today we have a new way of classifying it based on the genome and the power we can take from sequencing the genome to understanding what’s gone wrong in the cancer cell.

Today, that allows us to molecularly characterize a cancer, to define the specific mutations. One of the most common mutations was first found in skin cancer. 70 percent of patients that had the most lethal form of skin cancer, called melanoma, have a mutation in a gene called RAF. Today, because of the field of precision medicine we were able to drugs that effectively block the mutant activity, this enzyme called RAF. And that’s been a very effective therapy for melanoma.

Now, we thought for a long time that that would only affect this one disease of the skin. As we sequence more and more cancers from different parts of the body, we find that about five percent of all cancers, no matter where they arise in the body, have that same mutation. And the vast majority of them will respond to the same drug that the melanoma did.

So, for the first time, we need to share information across the different specialties — specialists in breast cancer, specialists in lung cancer, specialists in colon cancer have to share best practices to get the best we can out of this molecular era of what’s called precision medicine.

Craig B. Thompson is the president and CEO of Memorial Sloan Kettering Cancer Center.

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