What if we had to stop talking about “breast cancer”, “liver cancer” or “lung cancer”? That one “Vision of Disruption” that those responsible for research at the Gustave Roussy Institute would like to promote. According to researchers from the Villejuif Cancer Center (Val-de-Marne), we should stop classifying metastatic cancer by the organ of the initial tumor. Some cancers – and perhaps all in the future – should be defined by their molecular and genetic profile.
This is not an intellectual debate, doctors at Europe’s largest cancer center insist. “We have known since 2012 that sensitivity to certain immunotherapies is linked to high levels of PDL1 protein present on tumor cells, says Fabrice Andre, Head of Research Department. It took more than ten years for patients with cervical cancer with PDL1 expression to gain access to this therapy. » Because authorizations – and clinical trials upstream – were issued by organ: melanomas, then lung cancer, then gradually other locations.
The process was similar for the so-called anti-PARP drugs, which are useful for tumors presenting specific gene mutations (BRCA1 and 2): “We used it for ovarian tumors, then breast, then prostate and finally pancreas. We can consider that 300,000 patients did not have this treatment because we reasoned by organ. »
Gustave Roussy begins to apply this new approach: “Besides the organ expert groups, we have the first so-called agnostic committee, which considers cancers with common anomalies”, describes its General Director, Professor Fabrice Barlesi.
Changing focal length doesn’t happen overnight. Because the history of oncology is tied to the primary location of cancer—which meant when surgery and radiotherapy were the only treatments. Because the mechanisms or susceptibility of all tumors are not well known. But this vision, which was the subject of an article published on Thursday Nature
It may be from the future. The US Food and Drug Administration has also granted some approvals for anti-cancer drugs without specifying the organ. (TagsToTranslate)Cancer
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