Guest column: People aren't alike, neither are their cancers

We are pleased to announce that genomic medicine, delivered in real time, is available in South Carolina for the first time. Thanks to an innovative Greenville Health System partnership with Selah Genomics, a new gene-based diagnostic test is paving the way for quicker, more precise and potentially far more effective cancer treatment at GHS.

When it comes to cancer treatment, one size does not fit all anymore. Emerging science shows that we have exhausted what can be achieved with the traditional approach of categorizing and treating cancers by their anatomic site of origin - for example, lung or breast. By investigating the mutations, or alterations, in the genes that drive a person's cancer, we can harness genomic medicine to better target exactly what drugs work best on an individual's specific cancer.

Don't think of this as a new treatment; think of it as a better way to tell which treatment will work best on which cancer.

Many have sought the promise of personalized cancer care, and much remains for us to learn. Nonetheless, progress by GHS and its Institute for Translational Oncology Research (ITOR) has resulted in mutational analysis of six common cancers, including ovarian, breast, colon, pancreas, lung and melanoma. Thanks to this and other research collaborations to be announced in the near future, patients in the Upstate will soon have access to gene-based testing that will rise to the level of the world's most advanced cancer programs.

Last week's announcement is a landmark accomplishment for the innovative partnership between GHS, ITOR and Selah Genomics, itself a product of Upstate ingenuity by way of Clemson University.

Malcolm Gladwell, noted author and journalist, is quoted as saying that "one of the great scientific revolutions over the past 15 years is the movement away from conformity and universals toward human variability." We believe he is right. The ability to analyze DNA and its transcripts, coupled with the power of super computing, allows for exponential progress in many fields, but probably nowhere is that more evident than in cancer.

We will use this system-wide program to begin integrating genomic analysis into the routine care of our cancer patients. Patients who have their surgeries at GHS campuses and treated at the GHS Cancer Institute or one of its satellite offices throughout the region can opt to have their tissue tested and give their doctors the opportunity to take advantage of unanticipated targets in cancer. For some patients, this could lead to treatments not typical for the type of cancer - but potentially more precise for their unique cancers.

Additionally, the identification of these targets will more routinely allow patients to participate in clinical trials of newer medications. Many of these types of trials are available in ITOR's Clinical Research Unit, the largest phase I oncology drug development unit of its kind in the state. The new program will also enhance our ability to attract even more leading-edge studies.

To truly embrace and use this gift of technological advancement - a gift that will penetrate and unveil the variability within a cancer subtype - requires collaboration on an unprecedented scale. No single institution or researcher can get there by itself - no matter how large or established.

We agree with the recent front-page article in Time, which said that collaboration was vital because the questions are too complex and there simply isn't enough statistical power for any entity to go it alone.

This new world of genomic medicine deserves collaboration from all parties to derive the greatest benefit for all. While commercials and billboards continue to proliferate, we are actively establishing significant collaborations with institutions that are equally interested in contributing to large databases which are the fertile ground from which new treatments will arise. This promise is at the heart of ITOR, which brings pharmaceutical companies and biotech partners together with genomic researchers, cancer care providers and their patients.

While the problem of cancer is vast, our patients themselves will contribute meaningfully to the solutions that the future holds. We simply cannot proceed forward in the ways of the past. Innovative trial design and clustering patients by mutational targets rather than cancer type is how we must proceed to effectively battle cancer.

Our intent is to democratize the availability to genomic medicine. We may not have a singular benefactor, but our unique Upstate community is particularly adept at setting and accomplishing goals. This community has raised funds by rowing dragon boats, eating countless plates of barbecue, playing hundreds of games of pool, riding bicycles up Paris Mountain, to Texas and now to the state of Maine - all in an effort to achieve these goals. It has truly been a herculean community effort.

This announcement is a gift back to those who have dedicated so much to make it a reality. For those who have championed this project, we are truly thankful. We have a diverse population, sophisticated medical expertise and the entrepreneurial spirit that is needed to take ownership of this most important endeavor.

And, we do not overpromise. There is clearly a long road ahead to make genomic medicine a reality for all. However, we know that with your continuing commitment and participation, we can keep the Upstate at the forefront of what is possible in gaining real ground in the war against cancer.

Guest Column Written by Jeffery Edenfield for greenvilleonline.com May 08

Dr. Jeffery Edenfield is the co-director of Greenville Health System's Institute for Translational Oncology Research.