In 2015, all the genetic data of any tumor will be known, according to Dr. Laurent Alexandre. Cancer could then be treated in a totally personalized way.
4 hours, 1 technician and about 1000 dollars is what it takes today to know for sure if this or that cancer treatment will work on an individual’s tumor. Dr Laurent Alexandre is a urological surgeon and president of the DNAVison company specializing in tumor sequencing. He is convinced that tomorrow’s oncology will be turned upside down by genome analysis: “Cancers are hereditary in only 10% of cases. On the other hand, all the others are genetic, because of an instability of our DNA often caused by environmental factors such as tobacco, alcohol or the sun. In other words, cancer is always a DNA disease which is usually acquired ”. The DNA that makes up our 23 pairs of chromosomes contains all the information that allows us to live and reproduce. The sequencing of our genome therefore amounts to drawing up our most intimate identity card.
Listen to Dr Laurent Alexandre, urological surgeon and president of DNAVison: “The oncologist will enter the world of astrophysics”.
Currently, it is known that chemotherapy only works if the tumor has a number of genetic variations in its own DNA. “We can just say, statistically, that such anticancer treatment will work in 30% of cases of kidney cancer, for example, adds Laurent Alexandre. But it is impossible to tell an individual patient whether his cancer will respond or not ”.
According to the National Cancer Institute (INCa), targeted therapy has already started well. In many cancers, doctors can already detect a number of genetic abnormalities in a tumor and offer personalized treatment. France is not late, on the contrary, it has even been involved since 2008 in a research program called the International Cancer Genomics Consortium. On the ground, it is even already palpable. INCa already finances and supervises 28 regional platforms capable of performing around 30 molecular tests determining the best cancer treatment for a given patient. “For the moment we can only decode around 30 genes, but in the next 2 years we will be able to do it for 50 to 100 genes,” explains Prof. Fabien Calvo, director of research at INCa.
Listen to Prof. Fabien Calvo, director of research at INCa: ” In metastatic melanoma, we already do it, we know that half of patients have a mutation in a gene that makes it possible to know what treatment the tumor will respond to. “
But what is the use of fully sequencing tumors knowing that we do not necessarily have as many drugs as there are genetic characteristics of a cancer cell? “We already have a lot of drugs, but obviously the discovery of new genetic features in tumors pushes to look for other molecules that will target them specifically,” predicts Laurent Alexandre. To be able to decode the entire genome of the tumors of Mr. Everyone, it will be necessary to wait at least 3 to 4 years.
For the moment, only a few billionaires who have cancer have already done so, this was the case of Steve Jobs, the founder of APPLE, who had the DNA sequence of his pancreatic cancer analyzed. What is certain is that doctors, surgeons or biologists will not be able to cope alone with this storm of data combining genetics and computer science. For the revolution to take place, it will be necessary to train and recruit new professionals, in particular a good number of bioinformaticians.
Listen to Dr Laurent Alexandre : ” Doctors are not used to processing billions and billions of information. This is a change in the organization of oncology and this requires a very strong reorientation of the training system. “
We will also have to wait for the cost of this technology to drop. But specialists say that this drop is inevitable. It took more than ten years and three billion dollars to obtain the publication of the first sequence of a human genome in 2003. In 2007, another whole sequencing is carried out in six months, eight in 2008, 500 in 2010. Today Now, it is possible to decipher an individual’s entire genome in just a few hours and for just a thousand dollars. Suddenly, it is not utopian to imagine being able to decode all the tumors of all cancer patients by 2015.
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