Pitt, UPMC Expand Use of Next-Generation Sequencing of Cancer Genes to Guide New Therapies

In a move away from a one-size-fits-most approach to treating cancer, the University of Pittsburgh and UPMC are significantly expanding capabilities for next-generation gene sequencing to provide personalized care for cancer patients. The aim is to find new therapeutic targets and create a more dynamic model of care for cancer patients. The program, initiated a year ago, has completed the analysis of 250 patients with advanced cancer who failed to improve with standard therapies.

In a newly expanded laboratory at the University of Pittsburgh, molecular pathologists are using a machine the size of a computer printer to sequence large regions of the genome in patients suffering from late-stage lung, colon, breast, and other common cancers. Under the direction of Yuri Nikiforov, vice chair of Pitt’s Department of Pathology in the School of Medicine, the research team now offers genomic testing, when clinically necessary, for UPMC patients with every cancer type, in every stage.

"The genetic alterations that lead to the dysfunction of cancer-related genes are important diagnostic, prognostic, and predictive biologic markers," said Nikiforov, who also is director of the department's Division of Molecular and Genomic Pathology. The program uses the Personalized Cancer Mutation Panel developed at Pitt, which can identify 2,800 mutations in 50 key cancer genes. Nikiforov added, "The newest technologies, known as next-generation sequencing, allow us to sequence numerous cancer genes at the same time, giving us valuable information about cancer mutations that can be targeted by new drugs, allowing for the use of personalized cancer therapies.

A multidisciplinary genomic tumor board has been established at UPMC CancerCenter to assess the new information obtained from sequencing and determine the best way to use it in the care of cancer patients. The board includes oncologists, pathologists, and other physicians and scientists involved in cancer research.

Mark Socinski, director of the Lung Cancer Section of the Division of Hematology/Oncology at Pitt's School of Medicine, participates in the tumor board and has seen first-hand how such sequencing can help patients. In one case, said Socinski—who also is codirector of the UPMC Center for Excellence in Lung Cancer and of UPCI’s Lung and Thoracic Malignancies Program—genetic sequencing helped identify new treatments for a 64-year-old suffering from lung cancer; scans done since the new treatments show the cancer isn’t growing.

“The spike in interest in molecular testing is fueled by the growth of targeted drugs that can be used based on the results of tumor profiling, and the most comprehensive way to do it is using next-generation sequencing,” said George K. Michalopoulos, Maud L. Menten Professor of Pathology and chair of the Department of Pathology.

Doctors and researchers caution that such advanced sequencing isn’t a cure-all for cancer, but it can offer the hope of new treatments for many patients.

“Genomics is not just the future of cancer care, but it’s happening right now,” said Nancy E. Davidson, Hillman Professor of Medicine in Pitt’s School of Medicine, director of the University of Pittsburgh Cancer Institute and UPMC CancerCenter, and associate vice chancellor for cancer research. “We’re taking what we learn directly from the bench to the bedside to help patients.”