When doctors choose a treatment for a patient today—for example a type of chemotherapy— they often rely on their own experience and information from previous studies of large groups of patients. Finding the best drug for a particular person is largely a matter of trial and error. By using genomic profiles as a guide, doctors now have the opportunity to move closer to "personalized medicine" in which medical treatment and prevention is customized for each individual patient.
Toward this end, our cancer genomics program is designed to unravel the underlying biology of cancer and to identify genomic and other clinical information that may be informative about an individual's risk for disease, or the likelihood they will respond to a certain type of treatment. Once we know more about which tumors are likely to be sensitive to which drug, this information may be tested in genome-guided clinical trials designed to select the optimal chemotherapy for each patient from the beginning of their treatment.
Before such new approaches can become part of standard medical practice, it will also be critical to build evidence showing whether new genomic biomarkers can be put to practical clinical use and whether doing so leads to improvements in patient outcomes in the real world. To address those questions and serve as a resource for future research, the IGSP's Clinical Genomics Studies Unit has developed a cancer registry collecting tumor tissue specimens annotated with medical history, laboratory results and genomic information.
Jen-Tsan Ashley Chi, MD, PhD is Assistant Professor in the Department of Molecular Genetics and Microbiology and works with the IGSP's research in genomic medicine. His research interests are to explore the use of DNA microarrays and other genomic tools to enhance our understanding of human diseases and disease-related biological questions.
Sandeep Dave completed an MS in Biomedical Engineering and was in the combined MD/MBA program at Northwestern University Medical School/Kellogg Graduate School of Management. His work is focused on the application of high throughput technologies to identify new therapeutic targets, as well as markers of diagnosis and prognosis in patients with leukemias and lymphomas.
David Hsu joined the IGSP in 2009 and also serves as an Assistant Professor in the Department of Medicine. Dr. Hsu research currently focuses on developing genomic strategies to improve prognosis and treatment of colorectal and other gastrointestinal malignancies.
Dr. Marcom's research has focused on two main areas. First, in the laboratory of Dr. Joseph Nevins in the Department of Genetics, he has been investigating alterations in cell cycle control in cancer. More recently, he has been involved with issues regarding genetic predisposition to developing cancer.
Dr. Joseph Nevins is Barbara Levine Professor of Breast Cancer Genomics. His research focuses on the gene regulatory events associated with the control of cellular proliferation and cell fate, including the dysregulation that contributes to oncogenesis.
John A. Olson, Jr. is Associate Professor of Surgery and a faculty member of the IGSP and its Center for Genomic Medicine. Dr. Olson's research interests include development and clinical testing of complex biomarkers to direct therapy in breast and endocrine diseases, and investigation of molecular mechanisms of parathyroid development and neoplasia.
Neal Ready, MD, PhD received his MD from Vanderbilt University School of Medicine (Tennessee) in 1986. He received his PhD in Biology from the University of California, Irvine in 1982. His clinical research interests revolve around the treatment of patients with lung cancer and head and neck cancers. His is active in multi-modality treatment, clinical-trial development, and translational research.
Comparative Effectiveness Research in Cancer Pharmacogenomics:
Vexing questions in the field of genomic biomarkers are: How do we build the evidence to support their clinical use? And what is their clinical value? The objective of this NCI-funded program led by Geoff Ginsburg, MD, PhD, and Gary Lyman, MD, is to develop an innovative framework for clinical effectiveness research (CER) for cancer pharmacogenomics. Specifically we have coordinated expertise from three existing state-of-the-art and unique entities at Duke – the Duke Institute for Genome Sciences & Policy Cancer Pharmacogenomic Biomarkers Program (IGSP-CPBP), the IGSP Clinical Genomics Studies Unit (IGSP-CGSU), and the Duke Health Services, Effectiveness and Outcomes Research Program (DHSEORP) - into a single entity, the Duke Center for Clinical Effectiveness of Cancer Pharmacogenomics. This new Center will be part of a network wholly focused on CER for genomic and personalized medicine in cancer. Developing a longitudinal sample and clinical data registry for cancer patients treated in the Duke Health System is a major emphasis of this project. The registry will provide the opportunity for discovery and validation of cancer biomarkers developed at Duke and also from the published literature.
Using Genomic Profiles to Predict Tumor Response to Chemotherapy:
Several clinical trials done in collaboration with the Duke Comprehensive Cancer Center are underway to study whether genomic profiles can determine the best anti-cancer drugs for patients with a various forms of cancer, including metastatic hormone-refractory prostate cancer, lung cancer and head and neck cancer. Another trial is testing the use of genomic profiles to predict the chances that early stage lung cancers will recur.
David Hsu, PhD, MD, Medical Oncology
shiaowen.hsu@duke.edu
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