Elevating Personalized Medicine to the Next Level of Precision

In this era of personalized medicine, innovative therapies are targeting the genetic fingerprint of an individual’s cancer cells to combat cancer more effectively with fewer side effects. Researchers with the Froedtert & the Medical College of Wisconsin Cancer Network have been at the forefront of personalized medicine. Now, they aim to push the boundaries farther with a clinical trial called I-PREDICT. 

“Typically, when a patient’s DNA is evaluated, we might find some changes and think one of them is driving the cancer,” said Ben George, MD, medical oncologist, MCW faculty member and co-principal investigator of the trial. “There may be one dominant change, but also a host of other changes in the DNA. Our question is: What is the composite effect of all these changes, as opposed to one or two?” 

For example, a patient may have a mutation in the ERBB2 gene. But among multiple patients having this change in common, physicians might find what they call companion alterations in other genes. 

“The behavior of the cancer is not likely determined by one change,” Dr. George said. “Instead, it could be determined by several. If we target multiple alterations, we may have a greater chance of keeping the cancer under control for a longer period of time.” 

The I-PREDICT trial is testing the effectiveness of tailoring therapies to individual patients’ unique molecular alterations based on information researchers collect from DNA, RNA and cell proteins. 

“Our molecular tumor board puts the data together and decides on a custom treatment combination for each patient,” Dr. George said. “No two patients are the same, and they will be treated based on their own molecular profile.” 

Study participants are treated with approved therapies. This can include a combination of chemotherapy, targeted therapies (to identify and eliminate specific types of cancer cells) and immunotherapy. Some of the drugs may target multiple molecular changes. 

“We look at the pathways involved in cancer’s development or progression, and the most efficient way to target alterations while minimizing side effects,” Dr. George said. “We’re treating with standard drugs, but the combination is often novel. We are also evaluating new drugs as they get approved to see if they can be incorporated into the treatment program.” 

The trial is for people with all solid tumors, such as breast, lung, prostate and head and neck cancers. It is open to people with early- or late-stage cancers and people who may have exhausted standard treatment options.