When President Biden reignited the Cancer Moonshot initiative in February, he stated ambitious goals, including halving the number of cancer-related deaths in just a decade. That national initiative has added fuel to the field of precision medicine.
"Anything that's genetic falls into the precision medicine field, and 95 percent of the time, they're talking about oncology," says Joseph Cohil, head of Synergy Oncology, a division of Synergy Laboratories. Also called personalized medicine, this specialty takes an innovative approach that delves into more than the name of the disease to determine treatment options.
Generally, patients diagnosed with a specific cancer would be prescribed the same chemo drug. "Now everyone can have a treatment specific to their genetic makeup, molecular profiling, and their diagnosis, which is much different than years ago," Cohil says. That precision optimizes the impact of existing treatments and helps alleviate trial and error with treatments.
Synergy, headquartered in Mobile, will soon be launching their own personalized medicine test. "Our test, which we've named TOTALITY, analyzes genes from a single tumor biopsy, providing physicians with a compact report that matches the detected molecular alterations with FDA-approved therapies and clinical trials," Cohil says.
The Human Genome Project, launched in 1990, worked to unlock the sequence of the human genome and identify the genes contained within. By the end of the project in 2003, they estimated that humans have between 20,000 and 25,000 genes. Each of these carry information to make the proteins in the body that determine, among other things, how well someone metabolizes food or reacts to infection.
Synergy's diagnostic test, which can be used for all cancer types, looks at 523 genes. "We know specifically what a lot of those genes do. Some are kind of exploratory. We know there's something important there," Cohil says. "The remainder are what we call future genes, a reflection of how vast and unmapped the field of genes remains in medicine. These are genes that we learn about as we go. So you can see how these tests are benefitting patients now and future patients."
The information collected from precision medicine tests not only adds to genomic knowledge, but also to drug development and treatments for cancer.
The information from each patient's test, once gathered from the tumor biopsy and blood sample, runs through a massive database of historic information on genetics, immune responses, biomarkers, and types of cancers. "It's a national database from a bioinformatics company we partner with," Cohil says.
This data of the molecular makeup of the tumor is so vast, and always expanding, that artificial intelligence is utilized to analyze the information quickly. The outcome is a list of options based on FDA-approved treatments, including what chemo drugs will work, as well as which drugs may not work. "Your doctor takes this and determines how he will treat you," Cohil says. "We look at the whole big picture. Everything we examine will help determine what the outcome is going to be."
A unique aspect to Synergy's TOTALITY test includes listing any pertaining clinical trials. National guidelines recommend all cancer patients be considered for clinical trials, but under five percent of patients participate. Most may not know they have the option or how to find these treatment trials. "TOTALITY brings clinical trials within their reach and identifies the appropriate trials based on their results," Cohil says.
Biden's cancer initiative has also helped lead this technology to become part of national guidelines. "This is great news for patients," Cohil says. "The American College of Gastroenterology has already recommended this technology in their guidelines. With personalized medicine tests being added into the guideline. It's a domino effect and the outcome allows us to create that perfect formula for treatment."