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Genomics 3.0: Taking the fear out of the C-word

Most of us will be touched by cancer at some point during our lives. Some will care for a loved one who is undergoing chemotherapy. Others might quietly mourn a favourite musician who has succumbed to the disease. Understandably, cancer is a scary topic for all of us. But promising advances in genomics are raising hopes that someday we may no longer need to fear the dreaded C-word.

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There are over 200 types of cancer. As a result, it is notoriously difficult to treat: because every cancer is different and each individual responds differently to the same medication, on average only 25% of cancer drugs are effective. And the side-effects of treatment are debilitating, as anyone who has ever battled cancer or watched a close family member undergo chemotherapy can attest.

Treatment tailored to the patient’s DNA
At its core, cancer is a cluster of abnormal cells that have multiplied uncontrollably as a result of a series of genetic mutations. This is where the promise of genomics comes in. Because cancer is rooted in genetics, genomic oncology could enable the sequenced genetic data across large populations to be collected and analysed over time as the DNA mutates. This data can then be compared to an individual patient’s DNA, allowing doctors to tailor treatment options according to that patient’s genetic profile, ultimately improving efficacy and avoiding unnecessary treatments.

Liquid biopsy: detecting cancer in a drop of blood
Today, a cancer diagnosis involves various steps. Typically a patient or doctor finds a suspicious growth or lump. A tissue biopsy is ordered. The patient is put under general anaesthesia. A tissue sample is collected and sent to a lab for testing. All this is followed by an anxious weeks-long wait for the results. Not only is this time consuming and invasive, but in some cases the disease can only be diagnosed after it is sadly too late for treatment to be effective.

But what if all it took to diagnose cancer was a simple blood test? New developments in liquid biopsy might make this possible within the next few years. The basic idea behind liquid biopsies is that genetic mutations detected in tumour tissues can also be detected in patients’ blood samples. The advantages are countless. Besides being far less invasive and far more cost-effective than traditional biopsies, test results are available almost immediately. This could help doctors evaluate the effectiveness of treatment on a regular basis, allowing them to make adjustments as treatment progresses.

Patients with a family history of cancer could also benefit from early screening through a liquid biopsy. And with early detection comes a greater chance of successful treatment—and survival. Post-treatment, liquid biopsies could help doctors monitor cancer survivors to ensure the disease remains in remission.

Immunotherapy: the battle of the T-cells versus the C-cells
Most traditional drug-based treatments merely treat the symptoms of a disease, rather than the underlying genetic cause. Gene therapy, on the other hand, aims to fix the genetic problem at its source by using a carrier such as a nanoparticle, a T-cell or a virus, to replace a faulty gene with a corrected version. Recent breakthroughs in immunotherapy – a form of gene therapy that harnesses the power of the patient’s own immune system – are raising hopes that cancer patients could be completely cured following a single course of treatment. In CAR-T treatments, for instance, the patient’s T-cells – which play a key role in the human immune system – are extracted, genetically reprogrammed to attack cancer cells and then reinjected into the patient.

The promise of scientific progress
While some of these technologies are still in their infancy, it is important to keep in mind that scientific progress is advancing at a mind-boggling pace. Just think back to when the Human Genome Project was completed a mere 15 years ago. Back then, it took USD 3 billion and a team of over 1,000 scientists across the globe working together for 13 years to decode the human genome. Today, gene mapping takes just a few hours and costs less than USD 1,000. As gene mapping costs are estimated to drop even further to around USD 100 in the near future, its use will naturally expand beyond current academic research to broader clinical applications. And as BioTech companies and life sciences tools providers continue to make improvements to gene mapping and gene editing techniques, we can all remain optimistic that more effective treatment options with improved outcomes and better quality of life for cancer patients may soon become a reality.

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