Doctors Study Tumors' Genetic Makeup to Design Therapy

Durham, N.C. — Matching the right chemotherapy drug to a breast cancer patient can be hit or miss, but researchers at Duke University are studying a way to make a successful match more predictable.

Researchers have been studying the genetic makeup of tumors and have found patterns that may allow them to better design individual treatments. The patterns may also be able to predict the risk of cancer recurring.

Duke oncologist Dr. Anil Potti is leading a study aimed at helping patients and their doctors make better decisions about treatment from the start.

Researchers looked at 1,000 breast tumor samples – matched with each patient's clinical information.

Using a computerized system, they found genomic patterns that indicate aggressive cancers and those least likely to recur.

“This is a genomic fingerprint. It's very unique to each individual patient with breast cancer,” Potti said.

Potti said the same information may help determine which patients would respond best to certain chemotherapy drugs and if they need chemo at all.

“It's a significant advance over what we currently do,” Potti said.

The findings are in practice at Duke in several clinical trials.

One approach is to use the tumor's genetic makeup to help choose traditional chemotherapy or an alternate drug that may be more likely to help an individual patient. That specific trial will involve 300 patients this spring.

Breast cancer survivor Celeste McKnight and her doctors faced decisions including whether she should have a mastectomy or lumpectomy and which chemotherapy drug to use. She said more specific information about her tumor might have taken the guesswork out of her earlier decisions.

“Decisions based on if it's a more-aggressive tumor and likely to recur, maybe I would choose to have mastectomy rather than lumpectomy,” McKnight said.

After being diagnosed in 2004, McKnight, 51, is now cancer-free.