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High Tumor Heterogeneity Confirmed

One biopsy may not provide enough information about the array of mutations in cancer to devise treatments based on a tumor’s genetic profile.

By | March 9, 2012

image: High Tumor Heterogeneity Confirmed Kidney cancer. Wikimedia Commons, Nephron

Kidney cancer.WIKIMEDIA COMMONS, NEPHRON

A new study in the New England Journal of Medicine traces the evolutionary trees of tumors to find a high degree of genetic heterogeneity and illuminate why even personalized cancer treatment may not be effective, reported Nature. A single biopsy will only provide insight into the mutations in one location; mutations associated with different prognoses or responsive to different treatments may be lurking in other sites, which could explain why tumors often become resistant to therapy after a period of success, according to ScienceNOW.

"We've known for some time that tumors are a patchwork of faults, but this is the first time we've been able to use cutting-edge genome sequencing technology to map out the genetic landscape of a tumor in such exquisite detail," author Charles Swanton, cancer geneticist at Cancer Research UK’s London Research Institute told Reuters.

Swanton and his colleagues traced genome evolution and looked for genetic abnormalities in human kidney tumors. Taking biopsies of one patient’s main tumor in several locations, as well as several metastases the researchers found that only 34 percent of the mutations identified were shared across all of the patient’s samples. Constructing evolutionary trees of two tumors showed that one lineage spawned the patients’ metastases while the main lineage supported the primary tumor, suggesting that treatments based on a biopsy from a primary tumor may not efficiently target metastases. Discovering which mutations are common within a tumor and between tumors could enable a more comprehensive treatment strategy, Swanton told Reuters.

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Avatar of: FDAmatters

FDAmatters

Posts: 3

March 12, 2012

Personalized medicine is coming, but it will be like biotechnology--a couple of decades before it becomes a reliable source of new treatments. 
This research is a stellar and sobering example of how biological complexity confounds our expectations that rapid advances in science will quickly lead to cures. For more on this topic, see my latest blog column "Biological Complexity and the Myth of the Low-Hanging Fruit," which creates a context for this tumor research and personalized medicine. The column is at:  http://www.fdamatters.com/?p=1.... 
For those interested in more on FDA policy and regulation, especially as it effects drug development, sign up (free) to get my weekly blog at www.fdamatters.com.

Avatar of:

Posts: 0

March 12, 2012

Personalized medicine is coming, but it will be like biotechnology--a couple of decades before it becomes a reliable source of new treatments. 
This research is a stellar and sobering example of how biological complexity confounds our expectations that rapid advances in science will quickly lead to cures. For more on this topic, see my latest blog column "Biological Complexity and the Myth of the Low-Hanging Fruit," which creates a context for this tumor research and personalized medicine. The column is at:  http://www.fdamatters.com/?p=1.... 
For those interested in more on FDA policy and regulation, especially as it effects drug development, sign up (free) to get my weekly blog at www.fdamatters.com.

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