Expert Q&A: Understanding a new approach to cancer treatment
Precision oncology expert Dr. Ben Ho Park sheds light on cancer treatment innovations.
No cancer patient is the same — and no cancer is the same, either. That’s why sometimes a one-size-fits-all approach to treating a certain cancer isn’t the best solution. An emerging tactic called precision oncology aims to rectify this, analyzing a person’s tumor right down to its DNA in order to create a targeted treatment plan.
Breast cancer expert Ben Ho Park, M.D., is the new director of Precision Oncology at Vanderbilt-Ingram Cancer Center. Here, we chat with Dr. Park about his groundbreaking research on the genetic events that lead to cancer, and what that means for the future of cancer treatment.
Question: In a nutshell, what is precision oncology?
Answer: DNA is the alphabet of our life. Every one of our cells, normal and otherwise, has DNA, with few exceptions. Cancer arises because that DNA mutates and gets altered. The end result is that you have tons of mistakes in your DNA in the cancer cells. So it’s taken us a long time to understand that and then to exploit it.
We’re at the precipice right now. We have the ability to take a patient’s tumor and understand what the DNA mistakes are — the alphabet of life that has now gone awry —that cause that patient’s cancer to grow.
It’s one thing to understand it. But then can we do anything about it? In some circumstances, we can. We have drugs that can target these DNA alterations. Not always. But sometimes we will have a drug that can make a big impact.”
Q: Who does precision oncology benefit, and what’s the process?
A: Someone with cancer, particularly patients with metastatic disease, would come in and get a consultation. We’d do a molecular analysis of their tumor. Then we’d discuss it in our molecular tumor board: What could we possibly do, if anything, to help this patient and get them drugs or on a trial that they otherwise would not have known about? That’s where the use of the term “precision” comes in.
Q: How does precision oncology differ from traditional oncology?
A: The paradigm in oncology is to treat patients based upon the type of cancer they have. If you have a breast cancer, you get X, Y, and Z; if you get prostate cancer, you get this. Now the questions are: What is the DNA composition of your cancer? And can we treat it with something that’s specific to that — with precision?
Q: What is a tumor board and why is it beneficial?
A: Oncology, in general, has always had tumor boards. For example, I’m a breast cancer oncologist, and we have a breast tumor board that cuts across disciplines. We have surgical oncologists, reconstructive breast surgeons, radiation oncologists, radiologists, pathologists, as well as the medical oncologist.
Oftentimes, we discuss tough cases where there is no standard of care, per se. We have to use our best judgment and expertise to figure out what is going to be the best path for this patient. Molecular tumor boards are exactly the same idea, but here we’re looking at molecular testing of a patient’s cancer.
The value of having a place like Vanderbilt and tertiary-care academic cancer centers is to bring in the expertise from across many different disciplines and departments and come up with a consensus of how we’re going to help these patients.
I also had this notion, based upon similar breast tumor boards, that we needed to grow this to help people all across the country — and the world. So we started a monthly virtual international molecular tumor board.
Q: What happens when a new treatment becomes approved to target a particular DNA alteration? How does Vanderbilt use precision oncology to help cancer patients already undergoing treatment?
A: Vanderbilt has these amazing informatic tools. We end up looking in our database, and we identify more patients who are potential candidates. We are going to help patients today and in the next few months because we’ve already got their sequencing data. And as new drugs get approved, we make the physicians and the health care providers know when patients are eligible for this new drug. So that is also precision oncology — just staying on the cutting edge and knowing what’s going to get approved and, the minute it does, allowing patients and the providers access.
The Vanderbilt-Ingram Cancer Center is a national leader in patient care and research. Vanderbilt offers the region’s most complete range of oncology care, from advanced imaging to team-based treatment options to genetic cancer medicine and the latest in therapies being studied in clinical trials. Learn more.