Personalized cancer treatment

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When someone goes through chemo and radiation to fight cancer, the most devastating news is that the cancer has come back. (WLS)

When someone goes through chemo and radiation to fight cancer, the most devastating news is that the cancer has come back. But now thanks to groundbreaking treatments tailored to each individual patient's genetic makeup, some may have new hope.

Joseph and Barbara Italiano have always loved taking walks. But when Joseph's salivary gland cancer came back a second time, everything changed.

"I got to admit for the first day or so I was saying to myself, 'I'm not going to do anything it's just a waste of time,'" he said.

Then he saw two of his grandchildren playing and changed his mind.

"And I said, 'I just can't not do something.' So I called them back and said I will do the chemo and that's when we went a little bit further and found out about this," he said.

For Joseph, the key to successful treatment may lie in personalized diagnostics.

"So for patients it's exciting because if they have finished the standard therapies and there are no other possibilities for them they can have their tumor tested," said Marcia Brose, MD, PhD, Director of the Center for Rare Cancers and Personalized Therapy, University of Pennsylvania.

Joseph did just that and found out that his tumor had a mutation that made him a candidate for what's called a "targeted therapy."

"So it really is the possibility of one, really personalizing it to the patient's tumor, and two, giving them a therapy they wouldn't otherwise have and that's hope," Brose said.

"Ok, we have a possibility here. I'm not going to say that this is a guarantee that it's taken care of, but it's longevity, the longer I can stick around, the better I think all of us feel," Joseph said.

And now the Italianos are confident they will enjoy many more walks together.

Since launching in 2013, Penn's Center for Personalized Diagnostics has performed more than 4,000 tests on patients with a wide range of cancers. Penn's Center is one of just a handful of such programs in the United States focusing on DNA sequencing to individualize treatment. Doctors say that Joe's last scan shows his cancer has stabilized, which indicates that the treatment is working at this point.

If you would like more information, check out medical breakthroughs on the web at

BACKGROUND: The Center for Personalized Diagnostics is a joint initiative between Penn Medicine's Department of Pathology and Laboratory Medicine and the Abramson Cancer Center to support precision medicine at Penn. Penn's Center for Personalized Diagnostics (CPD) is diving deeper into cancer patients' tumors with next generation DNA sequencing. The genetic tests help refine diagnoses with greater precision than standard imaging tests and blood work by spotting known mutations that can inform the treatment plan. Since it launched in February 2013, the CPD has performed more than 4,000 advanced diagnostics, representing a wide range of cancers.

TREATMENT: The CPD aims to uncover genetic mutations within a patient's own cancer that can allow for a more targeted and personalized precision treatment strategy. By integrating Molecular Genetics, Pathology Informatics, and Genomic Pathology for precision-medicine diagnosis, the CPD can help physicians provide an appropriate and individualized treatment plan for their patients.

NEW TECHNOLOGY: Precision genomic diagnostics can identify patients who might benefit from current, often cutting-edge therapies, while sparing those who do not have a particular generic signature from the costs and side effects of certain treatments. It can also reduce the time conventional diagnostics approaches require, allowing patients and their loved ones to make informed decisions when time matters most. Cancer is fundamentally a disease of the genome. Genome-guided mutation detection can empower the medical oncologist to select cancer treatment therapies specific for tumors harboring these mutations. While a mutation may only be detected in a small subset of individual cancers, taken together, these mutations are not rare and specific molecular changes exist in all cancers. The Center for Personalized Diagnostics currently offers two different cancer gene -sequencing panels:

A custom hematologic malignancy panel, focused primarily on AML, MDS and CLL and a more comprehensive solid tumor panel, containing 47 genes known to be mutated in a wide range of tumor types.

Stephen Graff

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at

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