Clinical OMICs - Issue 4 - (Page 10)

(continued from previous page) Less Invasive Sample Collection Photo © Angellodeco/Deposit Photos While the advances made in cancer diagnostics employing genetic sequencing have been significant in the past few years, commercial applications still rely on tumor tissue. In 10 Clinical OMICs May 29, 2014 Photo: Linda Bartlett/National Cancer Institute ularHealth and Foundation Medicine use sequencing data derived from the tumor cells and crunch it along with data from the research literature and other public sources to show not only which genes have aberrations, but also which of those genes are clinically relevant and boil it all down into a single report that doctors can use to help them make treatment decisions. "In the absence of mutational information, targeted therapies tend to not be very useful," Jackson added. "That broader view on the tumor is essential to increasing response rates, and it is that challenge that is being addressed today using more complex knowledge mining and data analysis methods." Above and below left: Highly invasive biopsies may soon be a relic of the past as researchers develop blood, urine, and cerebrospinal diagnostic techniques. many cases performing the biopsy to collect the tissue is a highly invasive procedure, and depending on the form of cancer or progression of the disease, may be contra-indicated. For this reason, researchers are now turning their attention to developing methods to capture and sequence DNA from blood, urine, and cerebrospinal fluid samples. Prime sources of genetic material in these fluids include circulating tumor cells, exosomes, and cell-free DNA, among others. Being able to easily collect and analyze these kinds of samples could have significant therapeutic value. For instance, lung cancer patients typically don't get a second biopsy should their cancer recur. Using urine or blood samples and sequencing DNA derived from these sources is potentially valuable to clinicians who could see the genetic signature of the new cancer and whether it had new or different mutations from when it was first diagnosed. "It really is the Holy Grail to be able to do genetic profiling in the blood," said Johan Skog, CSO, Exosome Diagnostics. "One of the big advantages is you can do this repetitively, so we can also do longitudinal studies which can help show treatment efficacy and better identify the different signature of the responders." Foundation Health's Miller said these potential sources of genetic material are very encouraging, and the company is currently assessing which are the most promising. That said, he envisions each source having a role in the future. "There are exosomes, there is cell-free DNA, there are circulating tumor cells," he said. "They are not mutually exclusive in www.clinicalomics.com http://www.clinicalomics.com

Table of Contents for the Digital Edition of Clinical OMICs - Issue 4

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Clinical OMICs - Issue 4