Precision Medicine Catalyzes Change in Cancer Care At Englewood Health, tumor board meetings are held weekly for a wide range of cancers, including brain, breast, colorectal, lung and lym- phoma, among others. In addition, a molecular tumor board meeting is held monthly to review data on the mechanisms of action within differ- ent genetic mutations. Kevin Yao, MD, chief of neurosurgery at Englewood Health, says that the weekly tumor boards allow Engle- wood Health to engage all relevant specialists in giving each patient a comprehensive opinion.
Through the TIME Trial Program, pa - tients whose cancers have not re- sponded to currently approved ther- apies are matched to open clinical studies of novel approaches based on the molecular profiles of their specific tumors. Patients with rare mutations that may not be treatable with currently approved therapies can access these trials and the ther- apies they are evaluating without having to travel elsewhere. “Our understanding of how genetics impact an individual’s predisposition to cancer and their response to treatment has transformed the landscape of oncology. Englewood Health’s commitment to genetics has not only elevated the standard of care we deliver, but also exemplified the power of precision medicine in improving outcomes for our patients.” — Tamar H. Goldwaser, MD medical director of the genetics program at Englewood Health
work, we know that they are at in- creased risk for recurrence,” Mikhail Tismenetsky, MD, a pathologist at Englewood Health explains. “Often, we see these spikes in ctDNA before we see a rise in certain biomarkers or even the presence of tumor on imaging, which means we can iden- tify cancer recurrence earlier and im- prove our patient’s prognosis.” With this data, oncologists at The Lefcourt Family Cancer Treat- ment and Wellness Center can either treat certain patients’ can- cers more aggressively or spare them from therapy that would impair their quality of life when they are unlikely to benefit from it. Englewood Health Investiga- tors Leverage Molecular/ Genetic Testing for Clinical Trial Participant Selection In addition to determining choices of treatment, the molecular signatures of patients’ tumors can also help identify those who may benefit from participation in clinical trials that are evaluating novel therapies—particu- larly agents that are designed to tar- get specific genetic pathways. At Englewood Health, Jill S. Mor - rison, MD, medical director of the hospital’s infusion center, is the prin- cipal investigator of one such trial, which is examining how to improve survival rates in women with specif- ic genetic markers in breast cancer. In addition, the Lefcourt Family Cancer Treatment and Wellness Center at Englewood Health is one of just 50 cancer centers nationally to have partnered with the TIME Trial Program.
Genetic Testing Refines Targeted Therapies in Cancer Care The field of pathology has undergone a change in recent years. In the past, pathologists were concerned about the histology of the specimen, looking at tissue samples and carefully clas- sifying what they saw. “But that only gets you so far,” ex - plains Ana Burga, MD, chief of the Department of Pathology at Engle - wood Health. “Now we are breaking the sample down to the genetic lev- el. If we find a certain mutation, we can use therapies that specifically target cancer cells (or molecular al- terations driving their growth), min- imizing damage to healthy cells and reducing side effects compared to traditional treatments like chemo- therapy.” Today, there is also a wider range of targeted therapies against spe- cific mutations than there were just a few years back, Dr. Burga notes. One example: Poly (ADP-ribose) polymerase (PARP) inhibitors are a group of medications that inhibit a particular enzyme, and their use has been approved for patients with the inherited BRCA mutation, as well as ovarian and other cancers. At En - glewood Health, tumors are tested for HRD (homologous recombina- tion deficiency) which, if detected, can also qualify patients for PARP inhibitors to treat their cancer, even if they do not carry a pathogenic BRCA1 or BRCA2 variant.
the molecular signatures for can- cers in individual patients. At Engle - wood Health, patients who present with stage II and, in some cases, stage III disease (colorectal cancer as well as other cancers with high recurrence rates) undergo what’s called an “Oncotype DX test” to identify the molecular signatures of their tumors. In addition to solid tumor testing, circulating tumor DNA (ctDNA) test - ing is utilized to evaluate molecular signatures unique to individual pa- tients’ tumors to determine their risk for recurrence. Results from ctD- NA tests can help guide treatment planning such as the need for che- motherapy after surgery. “If we see a spike or increased num - ber of ctDNA in a patient’s blood
“With this wide range of exper - tise, we can optimize the treat- ment plans for our patients and ensure they are receiving the best possible options,” he notes. Molecular, Genetic Testing Support Precision Medicine for Colorectal Cancer Molecular pathologists at Engle- wood Health are analyzing tissue samples collected from resected colorectal tumors and pinpointing
Tumor boards offer a platform for ensuring consistent evaluation related to diagnosis, treatment, symptom management, follow-up, and supportive care. These tumor board members share ideas on op- timal management, then pass this information on to the patient and their caregivers so that they have a better understanding of their dis- ease and treatment journey.
Breast cancer tumor board meeting
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