Blog | WE ARE THE HERETICS: Sequence that cancer! - NFCR

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Genomic Sequencing Explains How Herceptin targets HER2+ Cancer

WE ARE THE HERETICS:  Sequence that cancer!

Heretic: someone who believes or teaches something that goes against accepted or official beliefs        http://www.merriam-webster.com/dictionary/heretic

Here’s an important question: Did your friend’s oncologists sequence their cancer?

You’ve heard a lot about targeted cancer therapies recently.  This is all about molecular profiling, i.e., identifying genetic mutations on a cancer that tell the cell how much and how fast to grow. Sometimes the cancer cells have too many copies of these genes with abnormalities. When there are too many copies of these genes, doctors refer to it as “overexpression.” With some forms of gene overexpression, cancer cells will make too many of the proteins that control cell growth and division, causing the cancer to grow and spread.

An example of this is how some cancer cells make (overexpress) too many copies of a particular gene known as HER2. The HER2 gene makes a protein known as a HER2 receptor. HER2 receptors are like ears, or antennae, on the surface of all cells. These HER2 receptors receive signals that stimulate the cell to grow and multiply. But cancer cells with too many HER2 receptors can pick up too many growth signals and so start growing and multiplying too much and too fast. Cancer cells that overexpress the HER2 gene are said to be HER2-positive.

Herceptin works by attaching itself to the HER2 receptors on the surface of cancer cells and blocking them from receiving growth signals. By blocking the signals, Herceptin can slow or stop the growth of cancers that express the HER2 molecule. Herceptin is an example of an immune targeted therapy. In addition to blocking HER2 receptors, Herceptin can also help fight cancer by alerting the immune system to destroy cancer cells onto which it is attached.

Notice I didn’t say anything about breast cancer.  Or lung cancer.

21st Century cancer treatments don’t have anything to do with where the cancers are located.  Even though the FDA approved Herceptin as a breast cancer treatment, Herceptin has nothing to do with breast cancer.  Herceptin targets the HER2 molecule and it will work on any cancer that expresses the HER2 growth factor receptor.   Many lung cancer patient’s cancers express another growth factor receptor, the so-called Endothelial Growth Factor Receptor (EGFR) mutation. And while not all lung cancers carry the EGFR mutation, those that do are sensitive to two drugs that target the EGFR enzyme: Genentech’s Tarceva, and AstraZeneca’s Iressa.

A raft of clinical trials are under way exploring how to capitalize on these findings. Most of them are using Tarceva or Iressa in combination with different chemotherapeutic agents. We have identified 400+ unique genes known to play a role in the initiation and progression of many different cancers, and we are making new discoveries about the significance of these changes almost every day.

For patients and healthcare professionals, genomic insights are helping to transform the way cancer is treated. One-size-fits-all treatment approaches are being replaced by more targeted, personalized approaches. And for certain types of cancer, we can now identify specific genetic and genomic drivers of an individual patient’s disease.

By sequencing your friend’s cancer, the oncologists will have access to genetic and genomic information to match the cancer with a cancer treatment designed to target their specific cancer.  NFCR has funded the scientists who are making all this happen. I am working closely with Dan Von Hoff, co-founder of the Translational Genomics Research Institute (TGen) who developed Tarceva; with Dan Haber who is Director of the MGH Cancer Center, and with Raju Kucherlapati, first Scientific Director of the Harvard Medical School-Partners Healthcare Center for Genetics and Genomics.

I ask you about whether your friend’s oncologist had sequenced his tumor?

There are new companies and tests emerging that can rapidly turnaround fast answers to a large array of questions.

(adopted from a letter by NFCR CEO Franklin Salisbury June 2016, after the Albert Szent Gyorgyi prize was awarded to Mary Claire King, PhD.)