Better cancer tests produce better cancer treatments

Cancer treatment faces a paramount challenge: matching patients with the most effective therapies with better cancer tests. Recent University of Oklahoma research has introduced a promising strategy that could lead thousands of cancer patients to life-extending treatments.

Abdul Rafeh Naqash, M.D., assistant professor at the OU College of Medicine and a researcher at the OU Health Stephenson Cancer Center, significantly contributed to a study published in Cancer Cell.

This research compared two diagnostic tests to identify patients best suited for immunotherapy. This treatment is notably effective for those with high microsatellite instability (MSI), indicating the DNA’s reduced repair capacity.

IHC vs. NGS: Comparison of two cancer tests

The study contrasts the efficacy of immunohistochemistry (IHC) and next-generation sequencing (NGS) in detecting MSI.

IHC focuses on the presence of mismatch repair proteins, which correct DNA replication errors. In contrast, NGS offers a broader genetic examination, pinpointing mutations associated with MSI.

Subsequently, the findings were unequivocal. NGS proved superior in identifying patients with MSI. This suggests a paradigm shift in diagnostic practices could enable more patients to receive life-saving immunotherapy.

Despite IHC’s common use, this study highlights NGS’s greater sensitivity for detecting MSI. In 2022, using NGS with IHC could have identified an extra 1,510 colon and 3,891 endometrial cancer cases with MSI, benefiting 5,401 patients who might have been missed.

A vision for inclusive healthcare

Dr. Naqash elucidates the significance of these findings, stressing the importance of inclusive diagnostics. “Although IHC catches most cancer patients with high microsatellite instability, it doesn’t identify everyone,” he states.

The goal is to ensure the broadest possible access to immunotherapy, which has the potential to significantly diminish or even eradicate cancer in certain cases.

Navigating towards personalized medicine

This research not only highlights the need for reevaluation of current testing recommendations but also paves the way for a more personalized approach to cancer treatment.

The National Comprehensive Cancer Network recommends MSI testing for all new gastric and colon cancer cases. Yet, Dr. Naqash believes the strong evidence supporting NGS will shift standard care towards using NGS alone or with IHC, optimizing treatment strategies.

Dr. Naqash’s work on identifying biomarkers highlights the shift towards precision medicine in cancer treatment.

“My firm belief is that if we have the right biomarkers for the right individual, we can tailor therapy, minimize toxicity, and optimize efficacy,” he states. This method improves patient life quality and marks progress in making cancer less deadly.

The full study was published in the journal Cancer Cell.

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