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Genomics helps unravel blood cancer

iStock / Getty Images Plus / Jian Fan

Dr Susie Cooke

Head of Medical Genomics – Glasgow Precision Oncology Laboratory

Dr Philip Beer

Head of Genomic Strategy – Glasgow Precision Oncology Laboratory

Dr Daniel Hodson

Clinician Scientist Fellow -University of Cambridge

Genomics is hailed as one of the most exciting medical developments in recent years – but what will it mean for blood cancer patients?

“We’re only looking at the tip of the iceberg of what genomics can do in terms of haematological cancers,” says Dr Daniel Hobson, Clinician Scientist Fellow at the University of Cambridge.

As our understanding of genetics has developed, we’ve pulled apart many assumptions about cancers and can now pinpoint the genetic mutations that cause many of them.

Genomics is taking things a step further.

As we understand more about genes and their impact on cancers, we’re slowing unravelling the complexity of the disease and the way it behaves.

Genomics discoveries – common blood cancer is actually a combination of multiple diseases

One example is recent research into diffuse large B-cell lymphoma, the most common type of blood cancer.

We used to think this was a single type of cancer. However, thanks to developments in genomics, scientists have identified a much more complex picture.

There will be no overnight revolution in blood cancer treatment. But as our knowledge grows and technology advances, the evolution is certainly gathering speed.

As Dr Philip Beer, Head of Genomic Strategy at Glasgow Precision Oncology Laboratory explains, “What’s become very clear in the last few years is that it’s probably at least seven diseases, maybe more, and at a genetic level they are all quite different.”

These findings have the potential to radically change the way patients are diagnosed and treated – moving from a one-size-fits-all approach to a much more focussed one.

Personalised treatment taking the whole patient into account

Beyond treatment, because genomics takes into consideration all the important features in a patient’s genome, it can help to shape everything from diagnosis and prognosis, right through to the possible side-affects a patient may experience.

In short, “It has the potential to cause a major shift in the system,” says Dr Susie Cook Head of Medical Genomics at Glasgow Precision Oncology Laboratory.

The promise is huge, but, in reality there is a significant lag between what’s going on in the lab and what patients are experiencing.

While technology is helping to short cut a lot of manual processes, there is no way, as yet, of fast-tracking clinical trials.

Going back to the example of diffuse large B-cell lymphoma, we may know that there are seven subtypes, but it will take years to accumulate enough evidence via clinical trials to help shape treatment.

“There’s been a lot of hype that precision medicine will revolutionise healthcare, but it’s more of an evolution,” confirms Beer.

We need more data to continue learning

Beyond the practical limitations, work also needs to be done to build up a wider bank of data.

“It’s only once we collect genomic data and clinical data on everyone that we can be accruing enough to pair things up and learn useful things about how to treat patients properly,” confirms Hobson.

The good news is that the tide is starting to turn. Drugs are slowly being introduced based on low level genetic testing and the NHS has embarked upon a process to overhaul their genomic testing of cancer patients.

There will be no overnight revolution in blood cancer treatment. But as our knowledge grows and technology advances, the evolution is certainly gathering speed.

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