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Cancer atlas may help with detection, cure

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http://www.sun-sentinel.com/features/li ... -headlines

By Jean P. Fisher


Posted March 18 2007

RALEIGH, N.C. – The scientists in Chuck Perou's laboratory at University of North Carolina-Chapel Hill plot cancer genes like towns and roads on a map -- coordinates that one day will result in a cancer atlas guiding doctors to smarter treatments. In the next few weeks, Perou, a cell biologist and geneticist, will lead his research team in an analysis of hundreds of tissue samples taken from patients' lung, brain and ovarian cancer tumors. All three have limited treatment options and have never been thoroughly analyzed at the genetic level.

Advances in care for other types of cancers have shown that understanding the genetic characteristics of tumors can be clinically valuable.

When Jackie Elmore, 46, was diagnosed with breast cancer in February 2005, for example, her doctor didn't just diagnose a malignancy. Because scientists have already identified and studied several genetic subtypes of breast tumors, the doctor could tell Elmore that she had a particularly aggressive breast cancer distinguished by the overproduction of a protein called HER-2.

There was also good news: Researchers have been working on that breast cancer subtype and have developed drugs to treat it. Elmore enrolled in a clinical trial of Herceptin, a treatment designed specifically to combat HER-2 positive breast cancer.

"It has helped me -- I'm still living," she said, noting that her cancer has not resurfaced.

Breast cancer therapy isn't the only success of cancer genetics. The leukemia drug Gleevec was developed to target a specific mutation found in 95 percent of patients with chronic myeloid leukemia.

The Cancer Genome Atlas, which is funded by the National Cancer Institute, is an attempt to find similar genetic vulnerabilities in lung, brain and ovarian tumors.

"As of today, there is no `HER-2' for these tumors," said Perou, an associate professor of genetics at UNC-Chapel Hill's School of Medicine. "We just don't have those types of predictive markers yet."

The three cancers to be studied are big killers, accounting for 210,000 new cancer diagnoses each year in the United States, according to the cancer institute. Lung cancer is most prevalent and the biggest killer among the three, accounting for an estimated 160,000 deaths in 2006 -- almost 30 percent of all cancer deaths that year. Brain cancer kills almost 19,000 people each year and ovarian cancer takes about 15,000 lives.

If the results from analyzing those three cancers are promising, the institute hopes to expand the atlas to map the genetic mutations associated with all cancers.

Perou said the atlas could provide the basic science that helps medicine detect cancer earlier, identify patients who will respond to certain treatments and help identify new drug targets. His lab is one of seven centers selected nationally to launch the initial phase of the cancer atlas.

Mining genetic data for cancer cures is a slow business, though. Most drugs resulting from genome-based research take more than a decade to develop and win regulatory approval. Screening and diagnostic tests emerge more quickly, but still would be years away.

Perou said speeding the pace of research is one goal of the cancer atlas project. As his lab produces results, they will be posted immediately on a public Internet site. Research groups working on specific genetic mutations or cancer types may find key information that helps move their work forward.

"It's really meant to be a public scientific resource," Perou said. "I'm sure we'll learn important medical biology and hopefully we'll find a few new true clinical breakthroughs."

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