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The Personalised Medicine Revolution Is Finally Happening And It'll Change The Way We Think About Cancer

18 SEP 2018

This is one of six stories done in partnership with the Queensland University of Technology (QUT). Find out more about their amazing research and scientists.

Right now, if you're diagnosed with cancer, the organ it originated in is paramount. So you have 'breast cancer' or 'colon cancer', and for the most part, that will determine how doctors treat it.

But thanks to genetic advances, doctors are now changing the way they think about cancer, and are looking at your cancer's genes, rather than where it's located, to figure out the best treatment plan.

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In the future, the organ your cancer comes from might hardly matter.

Professor Matt Brown, from QUT, has been on the forefront of genetics research for the last few decades, uncovering the gene mutations that can make us sick, and developing drugs that can help stop them.

He works in near-patient research, which means he works with real-life patients as well as in the lab. And on top of his work with genetic diseases, he's been part of driving the shift in how doctors think about, diagnose, and treat cancer.

It's called personalised medicine, and it means we are now starting to look at diseases based on their genetic variations, rather than treating them all the same way across different patients - something that's proven inefficient and ineffective over the past few decades.

Since the sequencing of the human genome was completed in 2003, it's become cheaper and faster than ever to perform genetic testing in large numbers of people.

"We've been major developers of something called the genome wide association study (GWAS) for identifying genes in common diseases, and have applied that across a range of diseases including motor neuron disease, rheumatoid arthritis, and osteoporosis," Brown explains in an interview with ScienceAlert.

These GWAS are one of the best ways we have of finding gene variants in the population that mean you are more or less likely to get a disease.

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"We went from a situation where there was a dozen or fewer genes known for all common diseases, now there are tens of thousands known," says Brown.

But it's only recently that these results are really beginning to translate to how we treat diseases. And when it comes to cancer it turns out that the traditional way we've been doing it for decades isn't the most effective.

Traditional cancer treatments look specifically at the type of cancer you had (breast, lung, etc) and base your treatment mostly off that.

"A significant number of patients don't respond," Brown explains.

"All cancers are caused by mutations in DNA and if you just look at one cancer type such as lung or breast cancer, then those cancer types actually include cancers caused by several different mutations, which can respond quite differently to treatment."

Matt Brown 30(QUT)

Instead, researchers are using personalised medicine to sequence the cancer, find the mutations that are causing the cancer, and treat the cancer based on what those mutations say about how it was caused, and how it should respond to treatment.

"[We] link that up with databases which list the results of clinical trials and what people have shown in those clinical trials about the mutational profiles of cancers and the likelihood to respond to treatment," he adds.

"Then we provide reports back to the clinicians so that they can choose treatments, based on what the mutation was that was causing the cancer, rather than just the organ that the cancer came from."

To be clear, this isn't looking at the genetic mutations in humans that make them more likely to inherit cancer, such as the BRCA1 mutations. The doctors are actually looking at the mutations in the cancerous cells themselves.

That could affect the recommendation the doctor will give if someone should receive one chemotherapy agent over another, or whether surgery should be undertaken early.

And this isn't something that's years away. Currently in Australia, it's still pretty limited, but in many places in Europe and the US, this sort of thing is part of the standard treatment of cancer.

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"Overseas it's progressed much more rapidly, so comprehensive genetic sequencing is something that's fairly routine in the United States and Europe. In the National Health Service in the UK they are now providing whole genome sequencing for patients with major invasive cancers," says Brown.

But what is the future of this technology? Well Brown explains that particularly once we start sequencing our entire genomes, we're bound to find diseases that we just won't be able to treat. What do you do with that information?

"Patients might feel that they want to know the data, but then they get told that they've got a high risk of developing early onset Alzheimer's disease – which has no treatment – does that really benefit the patient?" Brown explains.

"At the moment we just don't look at those variants, because we know that there's no consensus about what to do with them. That's an ethical discussion that needs to be resolved."

But scientists like Brown and his team have helped huge numbers of people with their research already.

And if one thing is certain, it's that the age of the genome is definitely here.

We've partnered with QUT to show you some of the research their fantastic scientists are doing every day.

QUT's annual scholarship round is now open. Find out more and apply by 30 September to join QUT researchers solving real world problems.

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