Precision cancer treatment in Israel. Oncotests.

In most cases cancer is caused by a mutation of human genes.

Nowadays, our oncologists use new methods for cancer genomes-oncomarkers (DNA mutations) identification. This allows to identify not only cancer tumor type but also the impact of different drugs that are not included in the standard anticancer therapy. Thus, patient and doctor become to know what exactly will work on a specific tumor of a specific person. This treatment is used when standard protocols fail.

Genomics in Personalized Cancer Treatment

Cancer is caused by genetic, physical or hereditary abnormalities.

Each person inherits a set of genes from both parents. This gene which is available in almost all cells of the body and embodied in the structure of DNA strands. If in the cellular DNA a defect or mutation occurs, that may cause inclusion of cancer genes. Your body cannot control this process.

The defective cell continues to multiply that results in cancer. Mutations can occur as a result of exposure to endogenous and exogenous causes (for example cancerogenic chemicals, radiation, etc.). Only in а very small number of cases the mutation is inherited from parents. In many cases, the cause of the mutation remains unknown.

Hereditary cancers only cover 10-15% of all diseases, and the remaining cancers are influenced by environmental factors, infections and lifestyle. Mutations can appear due to the influence of endogenous and exogenous factors (for example, carcinogenic chemicals, radioactive radiation, etc.). And only in a very small number of cases, the mutation is inherited from the parents. In many cases, the cause of the mutation remains unknown.

This information helps scientists determine the risk of cancer in a person’s life.

Why it is important to identifying DNA changes in cancer cells

Detection of DNA mutations in cancer cells and the definition of genes-markers allows to develop personalized treatment – individual therapy protocol in accordance with a genetic profile of cancer tumor. Personalized therapy has an advantage when selecting the most effective treatment, in comparison to standard treatment previously underwent by patient: chemotherapy, radiotherapy, immunotherapy, targeted therapy and surgery.

Personalized treatment includes special anticancer drugs and cures directed against the mutating cancer cells. Such therapy has much less effect on healthy cells.

In many cases, due to early diagnosis the tumor can be removed by surgery. In some cases, such as colon cancer, breast cancer or prostate cancer, the question often arises whether a preventive treatment, radiotheraphy or chemotherapy is necessary. In such cases, doctor may recommend genetic tests for genes-oncomarkers.

Tumor molecular profile

The so-called molecular profiling in samples of healthy and cancer patients allows us to find the most effective individual treatment method for each patient. Information about the patient’s protein, genetic and metabolic profile is used to tailor the treatment to the needs of the individual.

A key attribute of this medical model is the development of concomitant diagnostics, in which molecular assays measuring levels of proteins, genes, or specific mutations are used to provide each individual with a specific therapy. This is accomplished by stratifying the disease, choosing the correct drug, and adjusting the dose to the specific needs of the patient.

Traditionally, treatment is based on pathological examination, symptoms of the disease, and treatment history. With the discovery of early detection markers in diagnostic science, it is possible to detect a number of types of cancer even before the onset of pathological symptoms.

These markers can be biochemical, epigenetic, genetic, visual, metabolic, and proteomic. Using more than one marker in the same sample usually increases the sensitivity and specificity of cancer detection, which helps the doctor diagnose the tumor quickly and accurately.

This information is important because, based on the presence and stage of cancer, individual treatment regimens can be developed, as is done by marker profiles. A pathological diagnosis (histological examination) is still the gold standard in clinical practice, but a molecular diagnosis with additional information may differ from a pathological diagnosis.

Molecular oncotests for personalized cancer treatment

In order to identify DNA mutations, our oncologists use special oncotests to determine cancer genomes and tumor markers. These genetic studies are performed using biopsy of tumor tissue or blood tests, and help to accurately determine the type of cancer, as well as determine the effect of different drugs on it. Oncotests help to choose the right individual cancer treatment protocol for each patient separately.

In order to prepare the patient for personalized treatment against a certain type of cancer and tumor mutations tests, following types of oncotests are applied:

⇒ The study of tissue samples (Tissue Panels) – sequencing genes-oncomarkers method on tissue sample.

⇒ The study of sample liquid (Liquid Panels) – sequencing genes-oncomarkers method on blood sample.

⇒ Inclusive genome-proteomic studies (Ultra-Coverage Genomic Proteomic). General genome sequencing of tumor cells on distant tissues.

⇒ Molecular oncotests for precision cancer treatment in Israel – Review