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What Gene is Driving My Cancer?

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Published on September 11, 2020

Genomic Testing and Basket Trials Offer New Targeted Therapies

Dr. Alexander Drilon, Chief, Early Drug Development for Memorial Sloan Kettering Cancer Center joins Patient Power co-founder, Andrew Schorr, to discuss a paradigm shift in treatment: genome-driven oncology. The basket trials are a new type of clinical trial that groups cancer patients by the gene driving their cancer instead of their cancer type. Dr. Drilon emphasizes the importance of discussing genomic testing with your doctor and how identifying and treating the gene driving your cancer can change medical outcomes. Watch to hear the full discussion.

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Transcript | What Gene is Driving My Cancer?

Identifying Cancer Through Gene Sequencing

Andrew Schorr:

Hello, and welcome to Patient Power. I'm Andrew Schorr in California, but joining us from Memorial Sloan Kettering in New York, is the Chief of Early Drug Development, and that is Dr. Alexander Drilon. Thank you so much for being with us, Doctor.

Dr. Drilon:

Oh, you're very welcome.

Andrew Schorr:

We usually think of us as having lung cancer or breast cancer, pancreatic cancer or blood cancer, and we have a lot in common with the other people with that sort of cancer site, if you will. But you're involved in a whole new world of saying that there may be people with cancer that occurred in different parts of the body and they have more in common because it's a certain cancer gene.

Dr. Drilon:

In the past, we had looked at cancer through the lens of the particular cancer type. Now, we know that there's a different lens by which you can group cancers together based on these gene signatures that we find on comprehensive sequencing.

And because we know that these signatures can be shared across different cancer types, and I'll also add and across the different ages, one of the new strategies we've developed is what we call the basket trial, where essentially, the trial is like the basket, and any patient with that particular gene can get into the basket regardless of what the cancer type is or what it looks like under the microscope. If I then give targeted therapy for that particular gene, do we see good responses across all age groups and across different cancer types?

One shining example of this is the NTRK gene, which we know can be found across many different cancer types and also can be found from infants who have cancer, all the way up to people in their seventies, eighties, et cetera.

Why Should Cancer Patients Pursue Genomic Testing?

Andrew Schorr:

How important is genomic testing do you feel now for patients with cancer?

Dr. Drilon:

It's really critical. And I always say, if you don't look for something, then you can't do anything about it. And right now, I'll highlight that there are three FDA-approved therapies that are approved across cancers, regardless, really, of what the cancer looks like under the microscope. These are TRK inhibitors and immune therapy for tumor mutation burden and MSI high. Those are very technical terms, but just goes to show how important it is to think about doing gene sequencing for any cancer type.

Now, of course there are issues such as insurance coverage for these tests. And there are some cancers like lung cancer, where it's probably not a big problem, but now that we have these approvals, I think that payers have to really catch up and recognize how critical this is across different cancer types.

Andrew Schorr:

So would you advise patients, if they're diagnosed with cancer, to really have a heart-to-heart with their doctor, "can genomic testing give us knowledge that could make all the difference for me?”

Dr. Drilon:

That's a question that any patient should be asking his or her provider. Beyond the approved therapies, there are many clinical trials now that are developing active therapies that someone could benefit from.

Andrew Schorr:

Dr. Alexander Drilon, thanks so much for all you do, sir.

Dr. Drilon:

You're very welcome. It's my pleasure.

Andrew Schorr:

I'm Andrew Schorr. Remember, knowledge and getting the right tests can make all the difference and can be the best medicine.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.


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