Recent advancements in science and technology are rapidly fueling progress in personalizing cancer therapy due to:
- Large amounts of data generated by research and clinical diagnostics.
- The increasing ability of machine learning and artificial intelligence to make sense of it all.
Selecting treatments based on genetics, ‘genetic fingerprints’?
Technologies such as high-throughput DNA sequencing are providing more and more precise insights into the processes that drive cancer. Tumor profiling can identify changes in the tumor’s DNA that cause cancer to grow and spread. With our increasing understanding of the aberrant processes in tumors, we are continuously striving to develop precision medicines that specifically target these abnormalities to destroy cancerous cells. In collaboration with the Hartwig Medical Foundation, Amsterdam UMC is working to obtain and analyze large scale DNA information from individual cancer patients to assess whether apt precision medicines are available that act upon identified personal tumor DNA signatures.
Navigating an ocean of data to discover individual treatments
With our increasing technological abilities to diagnose tumors, more and more data are generated for analysis. In order to navigate these oceans of data, supporting information technology platforms and the use of artificial intelligence are essential. By collecting individual patient information and subsequently combining all patient data for analysis, important evidence can be extracted by recognizing recurring events or disease patterns among subgroups of patients. This leads to better and more accurate predictions of which patients will most likely benefit from specific therapies. On the flip side, the identification of patients unlikely to respond can prevent ineffective treatments and reduce therapy related burden.
Radiotherapy tailored to individual patients
The recent introduction of the Varian Ethos™ therapy solutions at Amsterdam UMC underlines the progress that is being made to tailor cancer treatment to the individual characteristics of a patient. Ethos enables extremely accurate radiation therapy by using real-time high resolution medical imaging and artificial intelligence to adapt the treatment plan according the variability of the tumor's shape or fluctuations in the tumor's position due to changes in nearby organs. Consequently, individual patients receive adaptive radiotherapy specifically directed to their tumors, significantly reducing damage to surrounding healthy organs.
Cancer treatment made for the individual patient
Developments in immunotherapy against cancer have made it possible to educate a patient’s own immune cells to recognize and destroy certain blood or bone marrow-derived tumor cells. However, creating personal CAR-T therapy is still very expensive as the patient’s own immune cells are genetically modified in a laboratory, and grown in large numbers and scrutinized for quality control, before being administered as a personal cancer treatment. Amsterdam UMC was the first hospital in the Netherlands to implement this kind of immunotherapy in a clinical research setting. The outcome for some patients is very promising: in a recent clinical trial, lasting remissions were achieved in about half of the patients with initially a very poor prognosis. Important initiatives have been developed at Amsterdam UMC to create a CAR-T production facility, reduce associated costs, and make CAR-T therapy accessible for more patients.
Patients as a member of the care team
Finally, each patient can help shape the care they receive based on their needs and perspectives. Our doctors present possibilities for treatment and decide together with the patient on the preferred option. We listen to our patient’s feedback not only to determine the treatment is right for the patients’ needs and circumstances, but to help identify and share best practices, and to learn and innovate.
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