Gene-based medicine comes of age

A Woodlands physician and research scientist is on the threshold of a dramatic new approach to the effective diagnosis and treatment of disease − bringing new hope and enhanced healing options for victims of cancer.

The team of physicians and specialists headed by Dr. Lloyd E. Everson, CEO of the U.S. division of Molecular Health based in The Woodlands, is making news in the medical community for their innovative gene-based molecular testing that helps doctors develop custom cancer treatment regimens for individual patients based on their personal genetics.

“Gene-based molecular testing holds great promise in helping understand the mechanism behind cancer,” said Everson. “Providing treatment options based on a patient’s genetic makeup gives physicians a better chance at selecting effective treatment options.”

That’s important because 70 percent of cancer treatments don’t work, said Everson. Selecting the right mix of cancer-fighting drugs for a patient is an inexact science, often based on the past experience of physicians, oncologists and pathologists. Chemotherapy that works on one patient often proves ineffective in another.

“The problem is the cells are constantly changing and evolving over time as the cancer grows − cancer is not a uniform structure, nor is it static,” said Everson. “A given treatment might work if provided at the right time, but could be ineffective if administered at the wrong stage of the cancer’s development.”

Cancer morphology − and its treatment − can be influenced by age, race and environmental factors, but it is highly impacted by individual genetic issues. When it comes to healthy cellular activity, DNA is the blueprint and proteins are the building blocks. Recognizing the genetic makeup of an individual patient better positions physicians to identify treatment options that will prove effective.

developed tests that identify a patient’s genetic makeup from a sample obtained from their tumor. The individual’s DNA can then be sequenced by sophisticated analysis − focusing on either a targeted 500-600 gene panel or the analysis of the individual’s entire exome using a HiSeq 2500, a DNA sequencer by Illumina. The resulting data from genetic sequencing can be overwhelming, acknowledged Everson. The key to finding actionable information, from a therapeutic perspective, is the accurate and rapid analysis of this genomic sequence data and subsequent matching to potential targeted chemotherapeutic agents. In addition, Molecular Health, has developed a Safety Map tm tool to enable the physician to consider any adverse effects from other medications the patient may be receiving.

Combining personal genetic tumor data with treatment information on the most effective use of cancer-fighting drugs can potentially lead to a better outcome of chemotherapy programs. The resulting data will potentially help oncologists and pathologists select better therapeutic options for patients with cancer.

Next generation sequencing (NGS) helps healthcare professionals decipher and determine treatment based on DNA molecular data. With more than 100 FDA approved cancer drugs and another 850 under clinical development − many targeting one or more products of abnormal genes − the number of molecular variables influencing modern treatment options can be daunting.

“Our goal is to give physicians, oncologists and pathologists more complete information on which they can determine a course of treatment,” said Everson. “Molecular medicine holds the future promise and key to more accurate diagnosis and successful treatment.”

The analysis also helps the patient and his medical team understand the importance of outside factors that can impact the success or failure of a sophisticated drug therapy program.

“A patient treated with a targeted therapy that costs anywhere from $50,000 to $100,000 should not be open to compromise by a $5 over-the-counter medication that nullifies the therapeutic fidelity of the anti-cancer medication,” said Everson. “MolecularHealth has the unique capability to potentially identify and highlight these risks.”

Everson believes molecular analysis is the future of medicine. In five to 10 years, he believes everyone with cancer will have their tumor samples tested with either a targeted panel or possibly a full genome analysis to better assess the disease and determine treatment options. He also sees molecular medicine as being a benefit in the diagnosis and treatment of other diseases − diabetes, liver, autoimmune and others. But cancer is the disease in which genetic medicine will likely make the biggest immediate impact.

Cancer drugs can also be extremely expensive. The goal of MolecularHealth is to provide a science and evidence-based approach for selecting drugs most likely to benefit an individual patient with a particular set of circumstances − reducing uncertainty about which treatments to use.

“The promise of gene sequencing in medicine isn’t new,” said Everson, “but the practical application of using genetic data in a coordinated, target approach is a profound step forward. We are on the threshold of major breakthroughs in medicine.”

Because the practical benefits of genetic sequencing are new, MolecularHealth is not an in-network provider with all insurance companies at this time. Pre-certification or an additional level of patient payment may be required, but Everson believes the service will prove invaluable − and cost efficient − in helping determine appropriate treatment therapies.

“There is a great deal of interest in the worldwide medical community about the potential benefits of personalized medicine,” said Everson. “Genetic sequencing is an exciting breakthrough that will save lives.”