The developments of genetic testing and personalized cancer vaccines for patients with skin cancer
Grant McArthur, MBBS, BMedSci, PhD, FRACP, of the Peter MacCallum Cancer Centre, Melbourne, Australia, discusses the ways genetic testing is being carried out to date. First of all, there are some very specific tests on individual genes, which is used to select therapies for patients. A good example of this test is the test for BRAF in melanoma. Prof. McArthur highlights that there are other important targets as well, such as NRAS mutations, MEK inhibitors, and KIT gene mutations, which do also form a part of the planning for treatments for such specific mutations. The next area of greatest innovation to think about next is the genetic testing of tumors across large portions of the genome, looking particularly at the total mutational burden (e.g. number of single nucleotide variants), which is quite an interesting aspect given that there is some interesting clinical biology associated with highly mutated tumors, which could also respond better to some checkpoint inhibitors. Therefore, the large scale sequencing of many genes may be a diagnostic as we proceed to go forward with optimizing the selection of therapies for individual patients. Prof. McArthur states that ultimately, one of the most exciting things that have been presented at the 2016 World Congress on Cancers of the Skin (WCCS) and the Congress of the European Association of Dermato-Oncology (EADO) in Vienna, Austria, is the very interesting concept and development of personalized cancer vaccines, where one could sequence all the coding regions of the genome to find the neoepitopes, mutated antigens, that are unique to the tumor, and develop a tumor-specific personalized vaccine, which would potentially be used with anti-PD-1 therapies. The transition from looking at individual genes, towards understanding the entire genome, could potentially be ready within the next five years, and aid gene sequencing research in cancers such as melanoma, squamous cell carcinoma, Merkel cell carcinoma and basal cell carcinoma.
3 years ago
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