How Genomic Profiling Finds the Best Treatment for Cancer Patients

September 11, 2019
Comprehensive genomic profiling (CGP) is an advanced diagnostic testing method Bumrungrad oncologists are now using to match individual patients with the best possible treatment for cancer.  

Thanks to recent advances in the diagnostic testing field known as genomic profiling, doctors can match a patient’s test results to the specific cancer treatment with the highest likelihood of success. Here is a look at four important facts about cancer and genomic profiling that help explain the significance of this recent breakthrough, and how patients can benefit from it.

1. Genomic profiling is different from genetic testing. Genetic testing, also called DNA testing, is a more limited testing process than genomic profiling. Genetic testing typically focuses on a particular gene or set of genes. Genomic profiling analyzes all of a person’s genes — approximately 22,000 genes in total, though doctors tend to focus on the roughly 300 to 400 genes known to be highly associated with cancer — looking broadly at the genetic code in order to find gene alterations that produce harmful changes at the genetic level. In the case of cancer, gene alterations are associated with faster growth of cancerous tumors.

2. There are several types of profiling tests. Tests for cancer-related gene mutations, RNA expression testing, copy number variations (CNVs) testing, and others, analyze various types of genetic alterations to varying degrees of detail. In simpler terms, each testing method helps explain the story of how a particular cancer developed and what should be the target of the treatment.
 
Some of the genomic profiling tests provide genetic-prone insight, which is predictive information that can identify patients who are genetically predisposed to specific alterations. Some patients want to know about these kinds of future risks, while others prefer not to receive the information. For any of the genetic-prone tests, patient consent is always required before the tests are ordered. The doctor will explain beforehand the purpose of each recommended test and answer any questions patients have.
 
Bumrungrad has on-site facilities where some of the tests are conducted, while for others the hospital uses specialist labs overseas. Depending on the test complexity, results can take from a few days to three or four weeks.

3. Conventional cancer diagnosis has some limitations. The conventional way of identifying cancer is based on where the cancer is located in the body, e.g. breast cancer is in the breast and prostate cancer is in the prostate. Generally speaking, the location is the key characteristic a doctor would use to evaluate various treatment options and decide which is most likely to deliver the best patient outcome.
 
Using lung cancer as an example, the conventional process can in some cases fall short of identifying the most effective lung cancer treatment. One reason is that different lung cancer patients won’t necessarily respond in the same way to the same treatment. In addition, a patient’s lung tumors may have different alterations than the tumors of another lung cancer patient, while sharing similarities in alterations with other types of cancer. 

4. Scientists and Bumrungrad doctors collaborate on results interpretation. Genomic profiling yields a complicated set of test results that must be analyzed and interpreted before being put to effective use in a patient’s cancer treatment. Input from scientific professionals as well other oncologists can be especially helpful during the process of deciphering these test results.
 
Bumrungrad established its own molecular tumor board (MTBs), considered the best-practice process for evaluating patients’ genomic profiling results. The Bumrungrad MTB holds regular meetings with experts from molecular and other science disciplines, together with the hospital’s oncologists using genomic profiling in the treatment process. At the MTB, each new set of profiling results is presented, discussed and deliberated by the doctors and scientists.
 
The global medical community is currently in the early stages of a shift toward precision medicine, which holds the promise of individually tailored healthcare for each person’s unique health profile. Conventional cancer treatments are still highly effective, and most patients respond as doctors expect them to. But genomic profiling is making it possible to do even better, and the benefits it offers for diagnosing cancer and identifying the best available treatment can be significant. As the procedure grows in popularity, the benefits are likely to become even more compelling.



By Dr. Harit Suwanrusme, a U.S. board-certified specialist in Oncology and Hematology, Horizon Regional Cancer Center at Bumrungrad International Hospital
 

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