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Clinical GYN-ONC research and personalized treatment protocols at Yale

zsazsa1
Posts: 400
Joined: Oct 2018

Tonight I was at a lab tour and lecture at Yale's Gyn-Onc department.  Their physician clinician researchers are doing clinical research and personalized treatment that is of great interest to me, and I assume to the women on this forum. 

The physician researchers are performing genetic sequencing of tumors, and then designing patient-specific probes to detect several mutations that would identify a specific individual's cancer cells.  Periodic blood tests are analysed for the presence of tumor DNA, in order to detect recurrences about 9 months earlier than imaging can.  Potentially, targeted chemotherapy or immunotherapy that may be effective for that patient can then be started earlier, hopefully with better effect.  In addition, there is the potential that this could eliminate the need for periodic scanning to detect recurrences.  Of course, that is only of use if early initiation of targeted therapy demonstrates prolonged survival, but I for one would like the reassurance of a negative test, if it is valid, and would want to know earlier, for earlier planning, if it were available, even if it did NOT lead to extended survival time.

Live tumor specimens from surgery are frozen in liquid nitrogen, for future analysis and use as research progresses.

Live specimens of highly aggressive tumors, or recurrent tumors, are being grown in a mouse model using a lab strain of designer mice that all have severe combined immunodeficiency, so that the mouse doesn't reject the tumor.  Then various forms of chemo, chosen based upon the genetic mutations found in the individual's tumor, are tried on the mice, to see if that particular chemotherapy shows efficacy in the mouse model.  If it does, that chemo is then given to the patient.

It's not that these concepts are new - they've been around for anywhere from a few years to a couple of decades.  It's that these modalities are now being used there  for many patients, in an attempt to obtain better outcomes with less toxicity for many individual patients, as opposed to in just a few who are able to get into a trial.  As these protocols are experimental, they are not covered by most insurances, but Yale appears to be covering the cost of it through research grants, although of course they are always seeking funding.

cmb's picture
cmb
Posts: 433
Joined: Jan 2018

While it's true that some facets of this research into personalized treatment have been around for quite a while, utilizing the applicable tools in a systematic way for all the center's patients (and determining their effectiveness) will be a great contribution to research in this area.

Thanks for letting us know about this work.

Northwoodsgirl
Posts: 570
Joined: Oct 2009

How interesting! It would be a significant advancement to have one’s treatment so individualized and to detect earlier one’s cancer. Thanks so much for sharing what you learned. Awesome! Gives me further confidence that progress is being made although not fast enough as we know. Great to have access without being in a clinical trial. 

Lori

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