Aug 5, 2021 Customizing Cancer Care

Not all cancers are alike, not even all cancers that afflict the same organ. That’s why oncologists at Monmouth Medical Center (MMC), Monmouth Medical Center Southern Campus (MMCSC) and Community Medical Center (CMC) now use state-of-the-art tumor profiling to personalize cancer treatment to many patients.

With tumor profiling, doctors send a tissue or blood sample to a lab to be analyzed for biomarkers that may indicate what is fueling the uncontrolled cancer cell growth. Test results usually come back within a couple weeks. If results show that a particular gene is involved, for example, physicians may be able to start treatment with a drug that targets that gene. Because the approach is so tailored, doctors often refer to it as precision medicine.

“In the old days, we just gave a report saying there is a cancer,” says Seth Cohen, MD, Regional Director of Oncology Services for the Southern Region, which encompasses all three hospitals. “It’s better to say this is a cancer, this gene is promoting this cancer, and if you use this drug for that gene, you could have a great impact on a person’s life. Patients are living longer because these targeted drugs are out there.”

In addition, many precision medicine patients enjoy an improved quality of life during treatment because these therapies usually have fewer side effects than standard approaches, says Deanna Tiggs, MS, RN, AOCNS, Regional Administrative Director of Cancer Services at MMC, an advanced practice nurse who also works with the oncology program at MMCSC and has been caring for cancer patients for more than 30 years.

“I’ve seen a lot of changes with regard to treatment options, and with precision medicine we’re moving away from the one-size-fits-all approach and instead making treatment unique to the patient,” Tiggs says. “It’s remarkable to see the progression.”

Take lung cancer, for instance, in which tumor profiling is often done. “The way we treat lung cancer today is not just by knowing it’s a lung cancer,” Dr. Cohen says. “We treat lung cancer by knowing about the genetic profile of that lung cancer.” A lung tumor may harbor various genetic mutations. Knowing which mutation is behind a patient’s cancer and understanding the tumor’s molecular structure lets doctors select the treatment that is known to be most effective for that particular tumor profile.

Revolutionary Care

“There are a lot of aspects of tumors that 10 years ago we weren’t even looking at, but now when we look at them, we notice we could actually have a huge impact on patient care by getting the exact genetics of the disease,” says Dr. Cohen. “If we can find the switch that causes some of these tumors in some of our patients, we can really make a difference for their care. What I see today is just so revolutionary in terms of changing patient outcomes.”

In one of Dr. Cohen’s cases, a patient who had been battling salivary gland cancer for nine years is now cancer-free thanks to tumor profiling. The patient had been undergoing radiation and chemotherapy repeatedly to tackle the cancer, which had spread to his brain and bones. When genetic testing revealed he had a PI3 kinase mutation, Dr. Cohen treated him with an oral drug that targets that mutation. “Now this man is going fishing every day and looks great,” Dr. Cohen says.

In another case, a patient with rectal cancer underwent tumor profiling that revealed the cancer involved a HER2 mutation. Working in partnership with Rutgers Cancer Institute of New Jersey—the state’s only National Cancer Institute-Designated Comprehensive Cancer Center—Dr. Cohen was able to enroll the patient in a clinical trial that is testing a drug that targets that mutation.

Potential access to cutting-edge clinical trials at Rutgers Cancer Institute is a major benefit to cancer patients treated at Southern Region hospitals, says Dr. Cohen. “This is the standard of care at all three hospitals,” he says.

When Precision Medicine Matters Most

Though tumor profiling of a wide range of malignancies is now done for many of the hospitals’ cancer patients, it’s not warranted in all cases, Dr. Cohen explains.

“We don’t do the testing on all patients all the time,” he says. “If a patient has an early cancer, based on the therapies we have now, we would proceed with that standard of care. So we usually reserve this testing in more advanced cases or unique cases. We order it in rare diseases that might have genes that promote them and in patients where we need other therapeutic options.”

And not every tumor that gets tested may have a genetic culprit that can be targeted with available treatments, either. But it’s worth it for all cancer patients to discuss the possibility of tumor profiling with an oncologist, Dr. Cohen says. “For eligible patients, tumor profiling leaves no stone unturned.”

RWJBarnabas Health and Southern Region hospitals, in partnership with Rutgers Cancer Institute of New Jersey—the state’s only NCI-Designated Comprehensive Cancer Center—provide close-to-home access to the most advanced treatment options. Call 844.CANCERNJ or visit our Cancer Services page.