Individualized cancer therapy - the dawn of a new era

Diagnosis "cancer". Almost half a million people in Germany fall ill with this disease every year, and the trend is rising. However, research has made tremendous progress in recent years, so that despite the complexity of the disease, it is possible to speak with restraint of a departure into a new era - above throughout progress in developing individualized cancer therapy.

Individualized cancer therapy does not mean that the individual, i.e. the patient in question, is given greater emphasis in the form of better care. Rather, the individual genetic profile of each person is focused.

Cancer therapies proceed according to the more or less identical standardized scheme, i.e. according to the latest medical findings: First, it is determined by tissue examination which type of cancer it is, and then a corresponding therapy is prescribed. In simplified terms, this therapy works according to the "one-drug-fits-all concept". This means: One active ingredient is used to treat breast cancer, another is used to treat prostate cancer. If the treatment does not lead to success, the doctors have a few alternatives to choose from. However, the basic difficulty lies because it is unpredictable whether the treatment will affect one person suffering from cancer and not the other, although both may suffer from the same cancer. And this is what is changing with the concept of individualized cancer treatment.

A first milestone of the new approach was the discovery that cells of an organ, such as breast cancer cells, also differ in molecular terms - i.e. at the smallest level. The cancer cells in a certain organ are not the same in every patient. A second milestone was the recognition it depends on these differences if a therapy works. Not every chemotherapy for breast cancer therefore helps every patient. Today, for example, there are already four different breast cancer. Effective therapies are available for the first three groups, which make up about 85 percent of all cases, at least if they are detected early. These effective therapies are available because the exact nature of breast cancer forms is known. The medications are selected. No individualized therapy has yet been found in the fourth group of breast cancer patients. Besides surgery and radiation, there is also a more conventional chemotherapy available here, as was the case for a good deal of cancer. However, it can be assumed that the exact differences and particularities will eventually be investigated here as well.

Such a classification can progress even further and the treatment of cancer can become much more individualized. Over 200 different forms of cancer are already known. Behind them - and this is also new - are various forms of gene modification, also known as risk genes. The new challenge is not only to investigate the cancer cells themselves, but also to characterize them by their genetic profile. This has also only become possible since the first identification of the entire genome, i.e. all human genes, in 2001. However, while it took the scientists another ten years for this initial identification, new technologies can already decipher the genetic material within a few hours. In this way, scientists are looking for new risk genes. If the genetic profile of the tumour is known and if this genetic modification is found in a patient, it would be possible for doctors to assess whether a particular drug affects the patient. The individualised medicines of the future can then even intervene in the causes of tumour formation.

Gene analysis can then also be helpful in determining the risk of developing cancer at all. It is now known that not only the risk factors, such as smoking, are responsible for the creation of cancer, but also the risk genes in question. Risk genes are gene variants that favour the outbreak of a particular disease. Risk genes are known for many cancers. If, for example, smoking or another cancer-promoting factor is added to this, the risk of a disease becomes greater than if someone does not possess the respective risk genes. The more risk genes become known, the more revolutionary the concept of individualized cancer therapy can be. According to experts, cancer can be a disease that may be curable more often than it is at present. 

Copyright: Landeszentrale fuer Gesundheitsfoerderung in Rheinland-Pfalz e.V. (LZG) Germany