Dr. Alice Shaw explains that lung cancer is not one disease, but consists of many different mutations. By determining the mutation, physicians will be able to use targeted therapy treatments to treat an individual's lung cancer. Dr. Shaw cares for lung cancer patients at the Center for Thoracic Cancers at Massachusetts General Hospital.
We used to think of lung cancer as a single disease, but now, at Mass General, we appreciate that there are many different types of lung cancer. These different types can be defined by specific mutations or changes in the DNA of patients’ tumors. These mutations are very important because they make patients responsive to certain targeted or smart drugs, and this knowledge allows us to then personalize a patient’s cancer treatments.
In most cases, Mass General oncologist can make use of a patient’s previous biopsy sample so that another biopsy is not necessary. The testing typically takes about four weeks and at the end of the four-week period, we will have information on over 110 different mutations involving 13 different genes.
Once we know the genetic profile of a patient’s lung cancer we can now pair the patients with the best targeted therapy for their cancer. Targeted therapies, in general, can increase life-expectancy and also improve quality of life.
There’s already one targeted therapy, Erlotnib, that is widely used for lung cancer and there are many other targeted therapies that are under clinical development and at Mass General are available through clinical trials.
In patients who have specific mutations, targeted therapies for those mutations can work incredibly well to slow the growth of the cancer and control the disease, sometimes for months and sometimes even for years.
At the Mass General Cancer Center we offer all of our lung cancer patients comprehensive genetic testing. We know that the patients who are most likely to benefit from genetic testing are those who are young with a never or light smoking history. These patients are the ones who are most likely to have specific genetic mutations for which we have targeted therapies.
In the near future we plan to offer a comprehensive genetic profiling to all of the cancer patients seen at the Mass General Cancer Center. In addition, we are constantly adding to the mutation profile to identify more mutations and more targeted therapy options for our patients.
Going forward, it will be important to recognize that cancer is not just defined by the tissue in which it originates, but by the underlying genetic changes that cause the cancer to arise.
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