When your only focus is to fight cancer, you would be wise to assemble the world’s greatest medical minds and scientists and encourage them to collaborate on transformative programs and the most sophisticated oncology diagnostics and treatment.

At the Rutgers Cancer Institute of New Jersey, a team of internationally recognized physicians and researchers are doing just that. The Institute, in partnership with RWJBarnabas Health, is New Jersey’s only Comprehensive Cancer Center (and one of only 49 in the U.S.) as designated by the National Cancer Institute.



Driven by a singular focus and mission, world-class researchers at the Institute’s Precision Medicine Translational Laboratory are uniquely qualified, and poised, to help individuals fight cancer. As the name suggests, precision medicine is the business of selecting one target — in this case, a particular cancer — and assaulting it from all sides, with the assistance of forward-thinking, game-changing research.



Dr. Lorna Rodriguez, director of precision medicine oncology at Rutgers Cancer Institute of New Jersey, said investigators are using precision medicine (DNA analysis to find targeted therapies for cancer) to look for and examine abnormal changes in up to 400 genes. When a mutated gene is identified, she said, a precise treatment can be developed and “aimed” at that particular cancer growth.



“It’s building a better bulls-eye,” Rodriguez said. “Through our research, we are finding … mutations through the sequencing process and this results in the possibility of identifying additional treatment options.”



She noted that precision medicine is particularly important for people with rare cancers that have no standard therapy or those with cancer whose disease has stopped responding to traditional treatment. “Targeted approaches can afford alternate options,” she said.



The main goals of the Precision Medicine Program include:



Engineering innovative genomic alterations for investigation in cells and animals;

Identifying and characterizing genomic alterations for their impact on cellular functions;

Evaluating the sensitivity of genomically targeted drugs to related genomic alterations;

Understanding how specific genomic alterations affect cellular signaling pathways; and

Standardizing approaches and techniques to create genomically altered cell and animal models.

That may sound like a lot of medical jargon. Actually, however, it simply highlights the fact that nothing about cancer is simple.



It’s going to take a seemingly never-ending amount of brain power to conquer cancer. That’s why doctors and research scientists in the Cancer Institute’s Precision Medicine Program work side-by-side, combining their expertise in use of various biochemical and genomic procedures.



The result, predicts Dr. Shridar Ganesan, associate director for translational science and chief of molecular oncology at Rutgers Cancer Institute, will help to determine “therapeutic approaches based on genomic findings, aid in the development of clinical trials and related options, and provide supportive rationale for exploring new therapies.”



Ganesan is leading a clinical trial at Rutgers Cancer Institute that uses DNA analysis to examine rare cancers and those resistant to traditional therapies.



“In recent years we have learned that cancers that arise in one organ, such as breast cancer or lung cancer, are not just one disease, but rather a collection of distinct diseases with varying responses to different treatment strategies. We, therefore, need to examine many features of each cancer to better classify it and identify effective treatment,” Ganesan said.



While precision medicine efforts are being carried out at the nation’s top cancer facilities, the professionals at the Rutgers Cancer Institute are forging collaborations to ensure rapid discovery and dissemination of scientific findings.



As an example, Ganesan points to a collaboration between himself and two colleagues, Rutgers Cancer Institute research member Dr. Hossein Khiabanian, Ph.D., an assistant professor of pathology and laboratory medicine at Rutgers Robert Wood Johnson Medical School; and Rutgers Cancer Institute medical oncologist Dr. Kim Hirshfield, an assistant professor of medicine at Rutgers Robert Wood Johnson Medical School.



“We have developed a statistical method, LOHGIC (Loss of Heterozygosity-Germline Inference Calculator), to identify patients with potential inherited, germline alterations in tumor suppressor genes while estimating gene loss in cancer cells through targeted genome sequencing,” he said. Their research was published last month in the online edition of JCO Precision Oncology.



In the era of precision medicine, high-quality DNA sequencing of patient tumors has become an integral part of clinical care.



“Pathogenic mutations in genes associated with hereditary cancer syndromes can be routinely detected by studying these gene assays,” added Khiabanian. “There is a need for methods that allow early detection of these mutations and precise determination of their status to design effective therapeutic approaches.”



Inherited germline mutations contribute to 5 to 10 percent of all cancers. Specifically, hereditary breast and ovarian cancer (HBOC) syndrome is among the most common familial cancer syndromes



“Identifying these patients and characterizing their mutations have important clinical implications” Ganesan said.



Hirshfield said the doctors and researchers working in the Cancer Institute’s Precision Medicine lab are always striving to find ways to reach better outcomes for patients.



“We can better match patients with drugs that we have,” she explained. “Doing so informs us about how we can broaden our approach for doing bench and lab research, clinical trials and for partnering with industry and pharma to bring new and better drugs to patients so we can and improve outcomes.”

