Gene test promises cancer care gains

A new generation of personalised cancer treatments will move a step closer when the world’s first nationwide genetic testing programme for cancer patients goes into action in the UK next month, with support from the public, private and charitable ­sectors.

Cancer Research UK is leading the new Stratified Medicine Programme, which is designed to tailor each patient’s treatment to the genetic nature of the tumour. Although specific cancers are already tested under some circumstances to discover whether a particular drug is likely to work on them – such as Herceptin for breast cancer – this is not yet a routine procedure.

In the programme’s pilot phase seven hospitals and three laboratories will collect and analyse 9,000 samples from six common cancers: breast, bowel, lung, prostate, ovary and melanoma. The samples will be tested for a range of genes and mutations that doctors and researchers have selected as being likely to play a significant role in the progression of the disease.

This research phase is expected to lead after two or three years to a co-ordinated national programme of personalised cancer treatment based on genetic testing.

One aim of the pilot is to discover whether a more bespoke approach could produce cost savings for the NHS as it struggles with the impact of the government’s fiscal squeeze. It is also intended to determine whether more targeted treatment produces better long-term outcomes for cancer sufferers.

“Nowhere else in Europe or North America is trying to do anything so broad-based through the healthcare system, though individual cancer centres have similar programmes,” said Peter Johnson, chief clinician at Cancer Research UK.

Other partners in the programme include the government through the Technology Strategy Board and National Health Service, the pharmaceutical industry through AstraZeneca and Pfizer, and PA Consulting, which will provide managerial and information technology services.

“We need to make sure that all the institutions taking part follow common procedures, from obtaining consent to the lab testing itself,” says Ian Rhodes, PA’s head of technology and healthcare.

Stratified medicine represents an advance on generalised medicine, in which every patient with the same symptoms receives the same treatment, and a move towards personalised medicine, in which everyone’s treatment is based on his or her individual genetic characteristics.

In oncology the best treatment, whether drugs, radiation or surgery, depends very much on the patient’s genome and the mutations driving the cancer. Stratified medicine divides patients into treatment strata or groups on the basis of genetic tests but stops short of fully individualised medicine.

The Stratified Medicine Programme aims to develop a standardised process into which discoveries about cancer genetics can slot as they are made. It will be a two-way process, generating more data for research while making sure that patients benefit as far as possible from existing knowledge.

The first phase of the programme will receive direct funding of £16m ($26m) from the partner organisations. Extra activity in the NHS hospitals and labs will be covered by existing budgets.

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