Since the completion of the Human Genome Project, genetics have had a significant impact on all the specialities of medicine. No more so than Cancer, with the recognition and validation of the impact of genetic markers on the development and prognosis of the disease. In parallel, the advance of technology and the ability to sequence the genome prompted the increase influence of genetics in the treatment of Cancer and the development of personalised medicine.
Personalised medicine is defined as the ability to assess patient genetic characteristics and to use them to diagnose more accurately the patient disease, to treat with an improved outcome or to limit and predict adverse reactions to the disease or the treatment. Another branch of personalised medicine is, through the detection of genetic markers, the ability to predict an individual’s susceptibility to diseases and therefore work toward an improved prevention and support of the patient. Typical examples of personalised medicine are :
- Mutations of BRCA1 and BRCA2 genes involved in hereditary breast and ovarian Cancers: the knowledge of this hereditary mutation might prompt preventive surgery such as mastectomy and ovariectomy to reduce the risk of Cancer ;
- Biological markers (Minimal Residual Disease or MRD) used in a clinical setting to quantify residual Cancer or improve the detection of tumours before physical signs and symptoms ;
- Medications designed to target aberrant molecular pathways for a precise patient population within a disease type. If Gleevec® is often used as a reference, recently the impact on Crizotinib® on patients with ALK mutation induced lung Cancer was excellent and showed the potential of targeted therapies.
Although success stories exist, the complexity and heterogeneity of Cancer slows down and limits the efficacy of Cancer research. Therefore, to benefit from the full potential of personalised medicine, a complete research structure must be established. The need for routine genomics data, an integrated medical record system, personalised treatments and predictive tools are essential.
BRIO aims to support with the creation of a platform across Institute Bergonié and Bordeaux University Hospital the efforts of all Bordeaux clinicians and researchers to find and establish new protocols of treatment as well as set-up and reinforce the tools needed to do so.