Scientists crack 'entire genetic code' of cancer

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Scientists crack 'entire genetic code' of cancer

By Michelle Roberts
Health reporter, BBC News

Scientists have unlocked the entire genetic code of two of the most common cancers - skin and lung - a move they say could revolutionise cancer care.

Not only will the cancer maps pave the way for blood tests to spot tumours far earlier, they will also yield new drug targets, says the Wellcome Trust team.

Scientists around the globe are now working to catalogue all the genes that go wrong in many types of human cancer.

The UK is looking at breast cancer, Japan at liver and India at mouth.

China is studying stomach cancer, and the US is looking at cancers of the brain, ovary and pancreas.

These catalogues are going to change the way we think about individual cancers
Wellcome Trust scientist Professor Michael Stratton


The International Cancer Genome Consortium scientists from the 10 countries involved say it will take them at least five years and many hundreds of thousands of dollars to complete this mammoth task.

But once they have done this, patients will reap the benefits.

Professor Michael Stratton, who is the UK lead, said: "These catalogues are going to change the way we think about individual cancers.

"By identifying all the cancer genes we will be able to develop new drugs that target the specific mutated genes and work out which patients will benefit from these novel treatments.

"We can envisage a time when following the removal of a cancer cataloguing it will become routine."

It could even be possible to develop MoT-style blood tests for healthy adults that can check for tell-tale DNA patterns suggestive of cancer.

Russian roulette

The scientists found the DNA code for a skin cancer called melanoma contained more than 30,000 errors almost entirely caused by too much sun exposure.

Most of the time the mutations will land in innocent parts of the genome, but some will hit the right targets for cancer
Wellcome Trust researcher Dr Peter Campbell


The lung cancer DNA code had more than 23,000 errors largely triggered by cigarette smoke exposure.

From this, the experts estimate a typical smoker acquires one new mutation for every 15 cigarettes they smoke.

Although many of these mutations will be harmless, some will trigger cancer.

Wellcome Trust researcher Dr Peter Campbell, who conducted this research, published in the journal Nature, said: "It's like playing Russian roulette.

"Most of the time the mutations will land in innocent parts of the genome, but some will hit the right targets for cancer."

By quitting smoking, people could reduce their cancer risk back down to "normal" with time, he said.

The suspicion is lung cells containing mutations are eventually replaced with new ones free of genetic errors.

By studying the cancer catalogues in detail, the scientists say it should be possible to find exactly which lifestyle and environmental factors trigger different tumours.

Treatment and prevention

Tom Haswell, who was successfully treated 15 years ago for lung cancer, believes the research will benefit the next generation:

"For future patients I think it's tremendous news because hopefully treatments can be targeted to their particular genome mutations, hopefully... reducing some of the side effects we get".

Cancer experts have applauded the work.

The Institute of Cancer Research said: "This is the first time that a complete cancer genome has been sequenced and similar insights into other cancer genomes are likely to follow.

"As more cancer genomes are revealed by this technique, we will gain a greater understanding of how cancer is caused and develops, improving our ability to prevent, treat and cure cancer."

Professor Carlos Caldas, from Cancer Research UK's Cambridge Research Institute called the research "groundbreaking".

"Like molecular archaeologists, these researchers have dug through layers of genetic information to uncover the history of these patients' disease.

"What is so new in this study is the researchers have been able to link particular mutations to their cause.

"The hope and excitement for the future is that we will eventually have detailed picture of how different cancers develop, and ultimately how better to treat and prevent them."

BBC News - Scientists crack 'entire genetic code' of cancer

p.s : there is a video of Professor Mike Stratton. don't know how to post that. may visit the link.

 

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Fundamental cancer genome breakthrough

David Mark reported this story on Thursday, December 17, 2009 18:10:00

MARK COLVIN: Scientists are hailing that unlocking the complete genetic code of two of the most common cancers as a "fundamental moment in cancer research".

The mapping of the DNA of skin and lung cancers was reported today in two papers in the journal Nature.

The scientists have discovered 30,000 odd errors in the DNA code of melanoma and about 23,000 errors in the DNA of lung cancer.

The "map" of the two cancers could lead to new tests for cancer and new and better drugs that target mutated genes.

David Mark reports.

DAVID MARK: Barely a week goes by it seems, without the world's media breathlessly reporting one cancer breakthrough or another.

But today's announcement is in a different league.

Professor Michael Stratton from the Welcome Trust Sanger Institute in Cambridge worked on the papers that were published today in Nature.

MICHAEL STRATTON: So this is a fundamental moment in cancer research. From here on in, we will think about cancers in a very different way.

DAVID MARK: Professor Stratton and his colleagues have taken and compared the cancerous and normal cells of a person with melanoma.

They've done the same with another person with lung cancer.

MICHAEL STRATTON: We know, and we've known for 100 years now that all cancers are due to abnormalities in DNA, abnormalities in DNA which are present in the cancer but not in any of the normal cells of the body.

Today, for the first time in two individual cancers, a melanoma and a lung cancer, we have provided the complete list of abnormalities in DNA in each of those two cancers.

DAVID MARK: In the case of Melanoma, the scientists found around 33,000 mutations, the result of exposure to ultra-violet light.

They found around 23,000 mutations in lung cancer, most caused by exposure to cigarette smoke.

That works out to around one mutation for every 15 cigarettes for the average smoker.

MICHAEL STRATTON: And this is the complete list. So we now see uncovered all the forces that have generated that cancer and we now see all the genes which are responsible for driving those two cancers.

DAVID MARK: But while there are literally tens of thousands of mutations in cancer DNA, it's likely that only a handful of those mutations are responsible for making a cell cancerous.

Associate Professor Graham Mann is the Co-Director of Research at the Melanoma Institute, Australia.

GRAHAM MANN: In any given cancer the best guess would be that you need to change maybe somewhere between 10 and 100 genes to really contribute to all the major differences that a cancer cell has from a normal cell. But these new techniques and this comprehensive technology means that for the first time we're really going to know that we've got them all.

We know that somewhere in those 30,000 are all the changes that have turned that cancer from a normal cell into a cancer cell; that's really critical.

DAVID MARK: So there's still work to do.

But given lung cancer is the biggest cancer killer globally and Australia has the highest incidence of melanoma in the World, Associate Professor Graham Mann believes the new work is vital.

GRAHAM MANN: It's taking things up to a whole other level and it's almost like I guess we're moving to a situation like having a Google Earth comprehensive view of the way that cancer happens through damage to genes.

DAVID MARK: The work raises the prospect of new tests for cancer and new drugs which can very specifically target the mutations that are causing the cancers.

Professor Michael Stratton.

MICHAEL STRATTON: For individual patients we will see all the genes that are abnormal and are driving each cancer and that's really critical because that will tell us which drugs are likely to have an effect on that particular cancer and which drugs are not.

DAVID MARK: Associate Professor Graham Mann.

GRAHAM MANN: The other big side of this is that when you know all the genes that are involved, then we can basically move to the situation when a person comes with a particular cancer type, we'll be able to find out the specific things that are wrong with their melanoma as opposed to the next person's melanoma, because those are the things which make one person's prognosis better or worse than another and one person's outlook from treatment different from another persons.

And so I guess the label that's been given is personalised medicine and there's no question that that's changing the face of cancer treatment.

DAVID MARK: The work published today is just the British arm of a world-wide project to crack cancer's DNA.

It's known as the International Cancer Genome Consortium as Dr Andrew Penman, the Chief Executive Officer of the Cancer Council New South Wales explains.

ANDREW PENNMANN: There are still a huge number of these cancers to be studied so we can make sense of all this, but if we are to make progress we have to be able to exploit this huge treasure-trove of information that we have about genetics and cancer more effectively and this systematic approach, I think, lays the foundation for that.

MARK COLVIN: Dr Andrew Pennmann, Chief Executive Officer of the Cancer Council of New South Wales, ending David Mark's report.

PM - Fundamental cancer genome breakthrough 17/12/2009

 

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We're winning the war on cancer

Extraordinary scientific advances mean we can now look forward to an era when cancer is no longer a condition to be feared, says Karol Sikora, one of the world's leading experts in the disease.

By Karol Sikora
Published: 7:07AM GMT 18 Dec 2009

Grim beauty Deadly diseases under the microscope Photo: Wellcome Images

What does yesterday's exciting news of the complete DNA sequencing of two different cancers mean? It is a fantastic feat that promises great improvements in our ability to cure cancer by 2020, but it comes with a hefty price tag.

The numbers are stark. One in three of us will get cancer, and 1.5 million Britons alive today have either had it or have been treated for it. Globally, 10 million people will get cancer this year and this will reach 20 million by 2020.

Cancer is predominantly a disease of people over 60, so paradoxically, this is good news. The growing number of cancers is because there are more old people – and so fewer deaths among the young.

The most promising advances on the horizon come from our rapidly increasing understanding of the cog molecules that make cancer cells tick. That's what yesterday's excitement was about. Imagine that your car breaks down. The difference between you and the roadside repair man is that he knows what goes on under the bonnet, while you can't even open it.

So we can now compare the exact DNA sequences of five different cancers from real people. Painstaking analysis of these and other data will allow us to work out what went wrong. Eventually this will have a considerable impact on prevention, screening, diagnosis and treatment, and will herald a new golden age of drug discovery.

In the past 20 years, a huge amount of fine detail of the basic biological processes that become disturbed in cancer has been amassed, and the pace is quickening.

We now know the key elements of how signals for growth bind to cells and how messages can get corrupted, leading to uncontrolled growth or failure to die. These are fertile areas to look for rationally based, anti-cancer drugs. This approach has already led to a record number of new compounds in trials, currently estimated to be about 700.

Over the next few years, there will be a marked shift in the type of agents used in the systemic treatment of cancer. They will be precisely targeted to the defined abnormalities found in individual patients.

Because we know the precise targets of these new agents, there will be a revolution in cancer therapy. Instead of defining drugs for different types of cancer empirically and relatively ineffectively, we will identify a series of molecular lesions in tumour samples. Future patients will receive drugs that target these lesions directly.

The human genome project provides a vast repository of comparative information about normal and malignant cells. The new therapies will be more selective, less toxic and be given for prolonged periods of time, in some cases for the rest of the patient's life. This will lead to a radical overhaul of how we provide cancer care.

Personalised medicine, based on a set of novel molecular diagnostics, will allow us to give the right medicine to the right patient at the right time. Small black boxes into which patients put a blood sample will guide treatment and monitor its effectiveness. Tiny, implantable chips sending radio signals to a home computer will permit continuous monitoring.

Individual cancer risk assessment will lead to tailored prevention messages and a specific screening programme to pick up early cancer, with far-reaching public health consequences. Preventive drugs will be developed to reduce the risk of further genetic deterioration.

But in this bright future, the funding of cancer care will become a significant problem. Already we have seen inequity in access to the drugs Sutent for kidney cancer and Avastin for colon cancer.

For the moment, these drugs are only palliative, adding just a few months to life. But the emerging compounds are likely to be far more successful, and their long-term administration considerably more expensive.

As consumerism increases in medicine, patients will become more informed and assertive, seeking out new therapies and bypassing traditional referral pathways.

New financial structures will arise, with the pharmaceutical, insurance and health care sectors combining to enable future patients to choose the levels of care they wish to pay for, through insurance or directly.

By 2025, chemotherapy is likely to replace other treatments for many cancers. Cancer will become a chronic, controllable illness, like diabetes today. People living with cancer will receive care in attractive, hotel-like environments rather than hospitals, run by competing private-sector providers. Global franchises will use the web to disseminate treatment plans and control their quality.

This transition will bring new ethical dilemmas. The future will be decided by the interaction of four complex factors: technological success, society's willingness to pay, future health care delivery systems and the financial mechanisms that underpin them.

Cure will still be sought, but it will not be the only satisfactory outcome. Patients will be closely monitored after treatment, but the fear that cancer will definitely kill, still prevalent today, will be replaced by an acceptance that many forms of cancer are a consequence of old age.

Fast-tracking the diagnosis makes good sense. Cancer masquerades as many other less serious illnesses, so even the most experienced GP can't pick out who actually has the disease. The NHS is often a slow and cumbersome system in which to get the necessary tests. Many cancers have already spread by the time they are eventually diagnosed.

We are still the poor man of Europe in comparative studies of access to diagnostics, despite Gordon Brown's recent announcement that nobody will have to wait more than seven days for tests. Unfortunately this is aspirational propaganda.

Predicting the future is fraught with difficulties. Who could have imagined in the 1980s the impact of mobile phones, the internet and low-cost airlines on global communication? Medicine will be overtaken by similarly unexpected step changes in innovation.

For these reasons, economic analysis of the impact of developments in cancer care is difficult. The greatest benefit will be achieved simply by assuring that the best care possible is on offer to the most patients. This would be irrespective of their socio-economic circumstances and of any scientific developments.

But this dream is simply unrealistic. Technologies are developing fast, particularly in imaging and the exploitation of the human genome. Well-informed patients, with adequate funds, will ensure that they have rapid access to the newest and the best – anywhere in the world.

More patients will benefit from better diagnosis and newer treatments, with greater emphasis on quality of life. But innovation will inevitably bring more inequality to health. The outcome of the same quality of care differs today between socio-economic groups and will continue to do so.

It is the job of governments to ensure health equity for all their constituents. Living long and dying fast will become the mantra of this century. Profound challenges lie ahead.

Professor Karol Sikora is medical director of CancerPartnersUK and Dean of the University of Buckingham Medical School.

We're winning the war on cancer - Telegraph

 

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Professor Karol Sikora: 'Soon, we will be able to manage cancer'

In 20 years' time, cancer will be seen as a chronic illness, according to Professor Karol Sikora, a leading authority on the disease

By Professor Karol Sikora
Published: 7:04PM GMT 24 Mar 2009

Professor Karol Sikora: 'Screening programmes for cancer have already lead to great improvements in survival rates but we must go further'

In 20 years' time, cancer will be seen as a chronic illness that, more often than not, can be either prevented or controlled. At the age of 12, every child will have a mouth swab or a blood test to provide a DNA sample. This will be sequenced to reveal their genetic susceptibility to various sorts of cancer, and they'll be given advice accordingly – eat more tomatoes, don't smoke, take a particular new drug. In the same way that patients who have high cholesterol now are given statins to prevent heart disease, so people with genetic predispositions to cancer will be given the right treatments to stop the disease taking hold.

Those who do succumb will no longer lie in hospital wards dressed in pyjamas. Cancer will be a part of everyday life, a condition to be brought under control and managed at home, like diabetes. Eventually, a diagnosis of cancer will not be something to fear.

If you think this sounds far-fetched, look at the progress that has already been made. There are 1.3 million people living in Britain who have had cancer. According to a new study, published this week in the European Journal of Cancer, half of women and a third of men in England now survive the disease. Many forms of cancer that were once killers are now treatable. Better screening programmes, better diagnostic tools and better drugs have all helped improve patients' chances. If we lag behind European peers such as France, Sweden and Switzerland now, we can catch up if we have the will to do it. We have four major opportunities – and challenges – to grasp.

The first is technology. Progress will keep marching on: we will see developments in surgery, in the field of nanotechnology, for example, where tiny robots that don't leave scar tissue will be used in cancer-removal operations; there will be improvements in radiotherapy; and in the drugs that target the molecules that cause cancer. There are 40 drugs scheduled to be approved within the next two years, with a further 2,000 undergoing clinical trials. The potential benefits are enormous.

The second is diagnostics. Screening programmes, such as for breast and cervical cancer, have already lead to great improvements in survival rates but we must go further in the future. The DNA-sequencing kit I described above is available now – but it costs £1,000 per person. As prices fall, this sort of preventative technique will be used much more widely.

The question of cost feeds into the third challenge, which is society's attitude towards the sick and who should pay for them. As a nation we're already becoming both more selfish, losing some of the sense of solidarity with the suffering that underpinned the founding of the National Health Service. And yet, thanks to the internet, we're also much more aware than ever before of the range of treatments available for cancer, and more determined to get the best for ourselves and our family. The conflict between these positions – wanting the best, but not wanting to pay for it – will sorely test the NHS.

Once care has been paid for, it needs to be delivered; this is the fourth challenge. Hospital beds are bad places to receive care, and as there will be more people living longer with cancer in the future, we will need to integrate cancer into normal life. In the same way that diabetics monitor their own conditions, so cancer patients will have little black diagnostic boxes in their homes. A network of local cancer day care centres would support patients and provide them with drugs and information.

We have a long way to go to improve cancer care, but we've also come a long way already. When I started as a junior doctor 30 years ago, we didn't even tell cancer patients what was wrong with them, to spare them the despair before they died. We won't wake up on May 2nd, 2015 and say, "That's it, cancer has been cured", but there will be lots of incremental steps to improving the situation.

In 10 years' time, I predict 60 per cent of patients will survive; in 20 years, 70 per cent; in 50 years, 90 per cent. Cancer can never be eradicated completely, but we can beat that sense of helplessness and horror.

* Professor Karol Sikora is a leading cancer specialist and Medical Director of CancerPartnersUK. He is Dean of the University of Buckingham Medical School and a founding member of Doctors for Reform

Professor Karol Sikora: 'Soon, we will be able to manage cancer' - Telegraph