University of Cambridge > Talks.cam > Cambridge Oncology Seminar Series > “Personalized Medicine in Oncology: The Dutch experience”

“Personalized Medicine in Oncology: The Dutch experience”

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If you have a question about this talk, please contact Mala Jayasundera.

Host: Dr Richard Baird

The costs of cancer care have become a subject of continuous debate over the last decade, for understandable but incorrect reasons focusing on the costs of cancer drugs. Yet, in a positive sense, this challenges us to also reconsider our current systems of cancer drug development.

In addition cancer care is increasingly becoming tailor made, which also creates a further challenge in the drug development process.

Some recent experiences with molecular targeting have been extremely positive, and it seems worthwhile to try to learn from these for future purposes. These recent experiences suggest, that if we have a sufficient understanding of the essential tumor growth driving factor, selective targeting might enable a development short-cut and reduce the numbers of patients required to lead the new compound to marketing approval. The examples of imatinib, vemurafenib, crizotinib, and trastuzumab may help in reshaping the development funnel for the future.

However, it should also be acknowledged, that the mentioned successes were achieved in situations with limited molecular abnormalities in cancer systems. The majority of our patients are facing a disease that is driven by multiple factors, rather than a single factor. And the evolution of disease is also paralleled by further genomic changes in either that single factor or in multiple factors, increasing the complexity of targeting as well as drug development. A single biopsy of the primary tumor that was removed long ago, may not suffice to guide treatment decisions for a patient that approaches for treatment of metastatic disease many years later.

All of these issues, including the dosing question that will not be discussed, have prompted us to set up the Center for Personalized Cancer Treatment (CPCT), a collaboration between Erasmus MC Cancer Institute, the University Medical Center Utrecht, and the Dutch Cancer Institute, with the aim to develop a system for both personalized drug development as well as personalized drug treatment. The center started late 2012, with harmonized contracts, protocols and procedures and a centralized DNA analysis. Deliberately the first studies were kept as simple as possible to be able to remove potential bugs from the system prior to entering the more complex study arena. The first years’ experience will be discussed. In view of the current achievements, we are considering to now rapidly extend participation to the other university hospitals in the Netherlands, therewith establishing a unique network with access to the vast majority of Dutch cancer patients.

This talk is part of the Cambridge Oncology Seminar Series series.

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