CSI Breast Cancer

csiI am a huge fan of the CSI series on TV – I am fascinated by the techniques, so I was intrigued to read today that breast cancer therapy that’s customized for each patient’s personal genetic makeup is one step closer to reality, thanks to a new use for crime-lab technology pioneered at Roswell Park Cancer Institute (RPCI).

A team led by Petr Starostik, MD, chief of RPCI’s Clinical Molecular Diagnostics lab, is using CSI-type methods to multiply the reliability of testing that predicts whether a given patient will benefit from a first-line chemotherapy drug, or should avoid it and its harsh side effects.

According to Dr. Starostik, better testing is one of the keys to “personalized medicine,” the long-sought solution to the problem that many drugs turn out to be ineffective for up to 50 percent of those who take them. “So far, we know that personal genetic variations in tumors affect each patient’s response,” he says.

The Starostik team’s innovation is a reliable, automated test for abnormal activity in the tumor-cell gene HER2, which marks patients who are unlikely to respond to the tumor-inhibiting compound Trastuzumab. While Trastuzumab is frequently prescribed, its side effects are harsh. Today’s HER2 tests often yield ambiguous results, he says, partly because they rely on manual lab work and subjective visual analysis.

The new approach employs multiplex polymerase chain reaction (PCR) technology, which is widely used in applications ranging from the diagnosis of hereditary diseases to the forensic identification of “genetic fingerprints”. Multiplex PCR is faster, more sensitive, easier to perform, and less costly than manual HER2 testing.

“Is personalized medicine achievable? I’m sure it is,” Dr. Starostik notes. “We just have to keep in mind that manual testing in this arena is impractical, no matter how skilled the lab personnel may be. But by taking advantage of powerful, new, automated tools, we can make more and more therapies specific to the genetic makeup of the individual and his or her tumor.”

Roswell Park Cancer Institute