lunes, 2 de junio de 2014

Therapy: This time it's personal : Nature : Nature Publishing Group

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Therapy: This time it's personal : Nature : Nature Publishing Group

Therapy: This time it's personal

Published online
Tailoring cancer treatment to individual and evolving tumours is the way of the future, but scientists are still hashing out the details.
Brendan Monroe
Elaine Mardis and her colleagues first encountered 39-year-old Lucy (not her real name) in 2010 at the Genome Institute at Washington University in St Louis, Missouri. Lucy had been referred there after a confusing leukaemia diagnosis. Her doctors thought she had a subtype of the disease called acute promyelocytic leukaemia (APL) — one of the most treatable forms — which usually occurs when parts of chromosomes 15 and 17 get mixed up, or translocated, triggering overproduction of blood-forming cells. But other features of her chromosomes suggested that she might have a much more dangerous form of the disease and therefore need a bone-marrow transplant.
Mardis, co-director of the Genome Institute, is involved in a university initiative to use whole-genome sequencing and other analyses to launch precision attacks against difficult cancers. While her medical colleagues treated Lucy, Mardis sequenced Lucy's genome and that of her cancer and discovered that the leukaemia was indeed caused by a piece of chromosome 15 inserting itself into chromosome 17 (ref. 1). “Our chromosomal analysis indicated that she would respond well to traditional APL therapy,” Mardis says. In other words, the treatment she had already received should hold her cancer at bay — and no risky transplant would be needed.

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