What is personalised medicine?
Personalised medicine involves using information about a person’s cancer to help with the diagnosis and treatment. It is an area that researchers are still working on.
Cancer treatment usually depends on:
- the type of cancer you have
- how big it is
- whether it has spread (the stage)
In the past, everyone with the same type of cancer used to get the same treatment. But we know that this one size fits all approach doesn’t work for everyone.
As doctors learn more about cancer, they also learn about the differences between cancer types. For example, doctors know that there isn’t just one type of breast cancer. There are many different subtypes of breast cancer.
Genetic changes in cancer
Cancer cells have changes in their genes (DNA) that make them different from normal cells. Genes are coded messages that tell cells how to behave. These gene changes mean that cancer cells behave differently from normal cells.
Different cancers have also different gene changes. Researchers call this the genetic makeup of the cancer. Every person’s cancer has its own genetic makeup.
Personalised medicine is looking at developing treatments that target those differences.
Is personalised medicine available for me?
Personalised medicine is an area that researchers are still working on. But some people are already benefitting from this.
Whether personalised medicine is suitable for you depends on:
- whether scientists have identified particular gene changes for your type of cancer
- if there is a test available for that gene change
- if there is a treatment that targets the particular gene change
Tests on the cancer cells
There are a number of tests that look for changes in cancer cells. Ask your doctor if any tests might be useful in your situation. Some of these tests are already available on the NHS. You have them at the same time you have other tests to diagnose your cancer.
There are also a number of companies that offer private tests to people with cancer. They use the results of these tests to recommend personalised treatment. It’s worth knowing that the cost of these tests is often high, and the NHS doesn't always accept the results of private tests.
Personalised medicine treatment
Your doctor will discuss the results of your cancer tests. They will tell you what the best treatment is for your cancer type.
Doctors already use personalised treatments on a number of cancers. We have included some examples below.
Chronic myeloid leukaemia (CML)
CML is a type of cancer that affects the blood and bone marrow. Most people with CML have a change in a gene called BCR-ABL1. You may hear this being called the Philadelphia chromosome.
If your CML tests positive for the Philadelphia chromosome, you might have:
Epidermal growth factor receptor (EGFR) is a protein found on the surface of cells. EGFR helps the cells to grow and divide. Some lung cancers have a change (mutation) in the EGFR gene.
If your lung cancer has the EGFR change, you might have treatment with one of the following drugs:
Some lung cancers also have a change in a gene called anaplastic lymphoma kinase (ALK). If this is the case, you might have treatment with:
Some people with breast cancer have receptors for a hormone called oestrogen. They are called
Tamoxifen is a hormone therapy drug. It works by blocking the oestrogen receptors. Tamoxifen is only likely to work if you have ER positive breast cancer.
Some bowel cancers have changes in a gene called K-RAS. Drugs called cetuximab (Erbitux) and panitumumab (Vectibix) only work on cancers that have the normal version of this gene. Your doctor usually tests for this gene change before you start treatment with these types of drugs.
Melanoma skin cancer
Some types of melanoma have changes in a gene called BRAF. Doctors usually test for this gene change. You might have treatment with targeted cancer drugs such as vemurafenib and dabrafenib if you have BRAF positive melanoma.
Does personalised medicine always work?
Unfortunately, we can’t guarantee that treatment will work even when you had tests to look for gene changes.
A treatment might not work because there are other changes in the cell we don’t know about, or don’t have a test for yet.
Research into personalised medicine
Researchers in the UK and around the world continue to look into personalised medicine. They hope to:
- find out more information about the genetic makeup of each cancer
- develop new tests that can look for gene changes
- develop new treatments that target a particular gene change
Stratified medicine means looking at large groups of people to find out which treatments will work on which cancers. It’s one step towards personalised medicine.
Cancer Research UK launched a stratified medicine programme in 2010. The video below explains the aim of the Stratified Medicine Programme. The video is 55 seconds long.
Cancer Research UK’s Stratified Medicine Programme marks a new era of research into personalised cancer medicine. It’s looking to tailor treatment to groups of patients who share similar faults in their tumours, helping to match the right treatment to the right patient.
A tumour sample will be taken from each patient and tested for a specific set of gene faults. Patients who share the same fault in their tumours will be placed in the same group, or stratified. Our pharmaceutical partners will then provide each group with the drug to target a specific fault in their tumours. As new experimental treatments become available they can be added to the existing trial. And those showing no benefit can be dropped.
We want to ensure each patient gets the best treatment for their type of tumour.
In the first part of the programme (SMP1), researchers collected samples from around 9,000 people with different types of cancer. They looked at the different genetic changes in the samples. This information will be used for future research.
This study has led to the next part of the programme, called SMP2. This is testing for genetic changes in non-small cell lung cancer (NSCLC). Based on the gene changes found, people might be able to take part in the National Lung Matrix trial.
The 100,000 genomes project
The 1000,000 genomes project is an NHS research project. It aims to look for the genetic causes of cancer and other rare diseases in a large number of people.
Everyone who took part gave a sample of blood, saliva or tissue. Researchers are now testing these samples to look at all the genes inside the cells. This information is being stored in a secure national library. Approved researchers can access this information to study diseases and look for new treatments.
We will find out more about which treatments work with these and other cell changes as we continue with this area of research.
Cancer Research UK is working with the NHS and pharmaceutical and medical companies. We aim to develop more tests and treatments and make them available in the NHS.