Three Cheers

Personalised medicine, immunotherapy and gene editing will change how cancer is prevented and treated in the future

- Dr Jame Abraham

A 54-year-old teacher came to see me for a second opinion with metastatic breast cancer in 2014. Her cancer had already spread to her brain, liver and lungs. Because of the extensive lesions in her lungs, she couldn’t breathe and was on oxygen. Her pain was unbearable.

Her breast cancer was triple negative, which is an aggressive subtype of breast cancer (15 per cent). This type of breast cancer doesn’t express oestrogen receptor/progesterone receptor and Her-2 neu protein. Because this type of breast cancer is more common in patients with BRCA mutation (germline mutation), we tested her blood for that gene. Her testing showed that she carries BRCA 1 gene, which is seen in about 5 per cent of all breast cancers. Then we did next generation sequencing (somatic mutation) of her tumour. Her tumour had multiple mutations, including BRCA mutation.

Based upon all the information, we selected a treatment plan for her. That regimen included a PARP inhibitor (Olaparib), which targets the germline BRCA mutation. She was part of our clinical research trials using a targeted therapy. She is more than three years post completion of treatment and cancer free. She is working full-time, playing tennis and riding bike to raise money for cancer research.

As per the World Health Organization and the American Cancer Society, one in eight deaths worldwide is due to cancer, and it is rapidly becoming a global pandemic. There were 14.1 million new cancer cases and 8.2 million cancer deaths in 2012. But the good news is that major advances are happening in the field of cancer research and therapy. The three areas that will change the future of medicine, especially cancer treatment are: personalised or genomic medicine, immunotherapy and gene editing.

Personalised and genomic medicine