In the State of the Union address, President Obama emphasized the importance
of medical treatments tailored to genetic and other characteristics of
individual patients, otherwise known as personalized medicine.
Ever since molecular biologists Francis Watson and James D. Crick introduced
the world to the double helix in 1953, scientists have predicted an era
of personalized medicine in which each patient's DNA would factor
into treatment decisions.
We are now living in the early years of that genomic era. Science is continuously
making strides — from the discovery of biomarkers that can predict
how well a person will respond to a specific drug, to gene-based risk
assessments for a variety of ailments.
And now researchers and clinicians are expanding the definition of genomic
medicine to include not only the genetic makeup of a patient, but the
genes that make up his disease.
In the fight against cancer, World Cancer Day is a unique opportunity
to raise awareness in the areas of prevention, early detection, treatment
and care. Examining the DNA of cancer, we now realize that two patients
withcolon cancer actually have two very different diseases.
The genes that contribute to the development and progression of cancer
can be individually distinct. This is incredibly exciting. Instead of
treating "colon cancer patients," we are entering an age in
which we will recommend therapeutic options for cancer patients based
on their unique and individual illnesses.
At Hoag, we are developing an affiliation with the Keck Medicine of USC
to leverage the university's impressive technology and give Orange
County patients local access to some of the most cutting-edge genomic
medicine research in the world.
That doesn't mean we're going to eradicate cancer in Orange County
in a couple of years. Too many scientists made the mistake of promising
an end to disease more than a decade ago, when the first human genome
was sequenced. That didn't happen because, as it turns out, understanding
the human genome was just the beginning.
We now know that it's not just about mapping genes, but understanding
gene expression, or what happens when a gene goes awry. So too do we need
to understand that sequencing the genes of disease will at first yield
limited results. But the promise is significant.
Already our understanding of the cancer genome is changing the way we
approach certain diseases. Up until three years ago, melanoma was treated
almost exclusively (and not very successfully) with chemotherapy.
We now know that 50% of melanomas have a genetic mutation that helps cancer
cells grow, and oncologists are able to shrink these previously untreatable
tumors, albeit for a limited time, with drugs targeting that specific
No, we haven't yet cured cancer. But every day, our deepening understanding
brings us closer to a world where we can anticipate control over previously
Dr. BURTON L. EISENBERG is the executive medical director for the Hoag Family Cancer Institute
and the Grace E. Hoag executive medical director endowed chair.