MD Anderson Cancer Center Madrid has just launched a platform specifically designed by the Cancer Genomics Research team, which allows to predict chemotherapy toxicity in cancer patients through a genetic test. To do this, only a simple blood sample is necessary before starting treatment.
The new platform can already be used in any of the patients in the hospital, regardless of the type of tumor they have.
Its development has been carried out by Juan Fernando García, head of the Pathology Department and scientific director, José María Viéitez, head of the Digestive Tumors Section of the Medical Oncology Service and Gema Moreno, head of the Translational Research Laboratory.
The genetic test is able to identify and analyze the variants (polymorphisms) in the DNA that can condition a greater or lesser toxicity to the treatments. “A polymorphism is a variation in the DNA sequence that is present with a frequency greater than 1 percent among individuals in a population,” explains Juan Fernando García. In this way, the presence of one or several specific genetic variants in enzymes involved in the metabolism or transport of drugs present in a patient can mean their better or worse tolerance to chemotherapeutic treatment.
The main advantage of knowing these variants, notes Viéitez, “is that we can predict what toxicity a certain treatment will have the patient and, in case the analyzed variants indicate that it can develop severe adverse effects, we can opt for another treatment scheme ”In addition, he continues,“ in those cases in which there is no therapeutic alternative, in that treatment the dose can be adjusted and the follow-up of the patient can be adapted ”.
What allows this type of approach is “to advance in the so-called precision medicine allowing to know a priori what the patient's clinical behavior will be and avoiding, as far as possible, the development of additional adverse effects,” says Moreno.
To carry out the results, a simple blood sample is only necessary before starting the treatment just after confirming the diagnosis and before starting a pharmacological treatment. “It can be done at any time during the process and, in fact, the European Society of Medical Oncology (ESMO) recommends performing these types of determinations in case of unexpected toxicity with certain drugs such as 5fu. ” However, García clarifies, “the ideal is to use this platform preventively to customize the treatment from the beginning.”
At the moment, the response to conventional chemotherapy is essentially contemplated because it is where there is more documentation and scientific and clinical evidence, but the idea is to expand and update this platform as the research progresses in the future. “This knowledge about the toxicity or not of the cancer treatment has been acquired with the experience and the course of time and, in the case of targeted therapies or immunotherapy, there is still no such temporary route that allows us to accumulate the number of sufficient evidence ”, emphasizes the specialist.
The announcement of the development and implementation of the new platform was made on the occasion of the commemoration, on September 24, of World Research Day.