Elephants and Tea - Precision Medicine - 15

ratory-based research. I graduated with my
PhD in molecular medicine in 2019, after
studying RNA splicing in myeloid cancers.
After graduate school, I was surprised to
learn about GenomOncology (GO), a software
company headquartered in Cleveland,
which focused on improving clinical decision-making
for biomarker-based cancers.
I was hired at GO in October 2019 for the
launch of the new Content Team, which is
responsible for the accurate data curation
of all FDA approvals, NCCN guidelines,
clinical trials, and more in GO's database.
Both my personal history and my occuMy
team's job at GenomOncology is to
pation have afforded me what I'd describe
as front-row seats to the latest therapies and
treatment strategies in oncology. I've been
on both sides of the same coin-something
that drives me to this very day. Precision
medicine has come a long way from, in my
case, two biomarkers (ALK and EGFR) and
two approved targeted therapies (crizotinib
and erlotinib) in 2011. Entire new treatment
strategies have been developed since the
dawn of precision medicine. Initially, targeted
therapies made up the vanguard: one drug
with one, sometimes a handful, of targets
that could be prescribed if a patient were to
test positive for the target. Immunotherapies,
which aim to unmask tumors hiding
in plain sight from one's immune system,
now have indications that rival the targeted
therapies. Cellular therapies, long restricted
to hematologic malignancies, have begun to
make inroads into solid tumor oncology.
Something I've found to be inspiring in
my position at GO has been the readaptation
of older oncology treatments, like
chemotherapy and radiotherapy, for the
precision-medicine-era. Chemotherapies
can now be attached to antibodies to create
antibody-drug conjugates, thus providing
targeted delivery of chemotherapy, which is
the cause of many of its nasty side effects. A
similar strategy involves attaching radioisotopes,
commonly used to treat prostate
cancer, with an antibody, thereby making
radiotherapy a little more like a precision
medicine. These innovations are things
I never would have dreamed of early in
my illness.
A comfort
I take from my
job, and one
I'd like to share
with all fellow
survivors, is
that progress
is always
being made.
What we as
patients need,
however, is
enough options
to sustain us
until the magic
bullet is found.
simplify complicated treatment strategies
for oncologists. Ask any cancer patient and
you'll likely learn that time is the greatest
threat: waiting for test results, for treatments
to work, for new treatments to become
available, for a slot to open in a clinical trial-time
is the hurdle over which all cancer
patients must leap, ready or not. It is my
hope that my work at GO will cut down on
time, enabling oncologists to craft the best
treatment plan for each patient. Some NCCN
guidelines read like football playbooks, full
of flow charts and page jumps, while some
FDA-approved indications are (intentionally
or not) vaguely worded-which can quickly
become challenging work because we cannot
afford to be incorrect. Patients should take
comfort in knowing more people, beyond
their oncologists, are fighting for their lives.
My experience with targeted therapies,
chemotherapies, and radiotherapy likely
mirrors that of so many other patients: it
takes several types of therapy to control
cancer. Unfortunately, the older modalities,
like chemotherapy and radiotherapy,
have awful side effects. To this day, I have a
partially paralyzed left arm, never-ending
tinnitus, and damaged hearing, among
other things from (primarily) cisplatin and
(secondarily) radiotherapy. While there is a
cost for everything, precision medicine can
help lower the toll. My side effects from the
three targeted therapies, while annoying,
are far more manageable.
My history as a patient makes it clear
that one day I might need to rely on one
of the new treatments I described above.
A comfort I take from my job, and one I'd
like to share with all fellow survivors, is that
progress is always being made. What we as
patients need, however, is enough options to
sustain us until the magic bullet is found.
I'm realistic that a cure for cancer is an unlikely
outcome; rather, I am confident that
cancer will become a controlled disease.
Precision medicine is helping to make that
dream a reality.
Remember to keep your head up, and to
always ask for biomarker testing. l
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PRECISION MEDICINE ISSUE 2024
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Elephants and Tea - Precision Medicine

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