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Precision Medicine · Talking FACS

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  Welcome to Talking Facts and thank you for tuning in to cancer Conversations On Talking Facts,
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  a podcast collaboration between the University of Kentucky,
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  Mary Cancer Center and the UK College of Agriculture,
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  Food and Environments Cooperative Extension Service.
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  We will share with you the latest developments in cancer prevention diagnosis,
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  treatment and research from the experts at Mary Cancer Center.
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  Kentucky's only National Cancer Institute designated Cancer Center.
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  Talking Facts is hosted by the UK Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals,
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  families and communities to improve quality of life.
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  Hello and welcome to Cancer Conversations On Talking Facts.
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  This is your host,
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  Doctor Jennifer Hunter,
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  assistant Director for Family Consumer Sciences Extension at the University of Kentucky.
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  Today,
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  I'm pleased to be joined by Doctor Jill Coes.
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  Jill is a university research Professor of Pharmacy at the University of Kentucky and holds administrative positions at the Marquee Cancer Center as the Director of Precision Medicine.
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  Welcome,
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  Jill.
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  Thank you for having me.
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  So today's topic,
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  I think has an interesting title.
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  We're calling it Precision Medicine.
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  Can you tell our listeners what we mean by the term precision medicine?
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  Yeah,
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  I'd be happy to the way we used to treat cancer is everybody got the same treatment.
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  So if you had breast cancer or you had lung cancer or you got the breast cancer treatment or you got the lung cancer treatment.
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  But what we do now is we use a precision medicine approach where we look at the patient,
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  look at the specific mutations in that cancer and you get a treatment that is designed just for you.
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  So let's talk a little bit because you mentioned the mutations in this cancer and you had shared with me that cancer is caused by,
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  by different mutations that are sometimes present and maybe not present in something else.
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  And if we were specifically talking about,
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  let's say lung cancer,
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  what patients with lung cancer should have their cancer tested for mutations.
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  Basically,
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  any patient with lung cancer should consider it and all patients with stage two B and,
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  and greater or or higher should have this testing done.
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  So is this standard operating procedure that if,
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  if someone is diagnosed with lung cancer or at least at um the stage that,
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  that you just discussed that their physician or their medical team will automatically do or is it something that a patient needs to know to request?
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  Well,
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  we call this type of management guideline concordant care.
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  So there are national guidelines that recommend that you have this testing.
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  There are also insurance pays for for this type of testing,
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  but I think it's great for people to know about the testing and talk to and bring it up with their doctors first.
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  So how does an individual get tested if they need it?
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  There are basically three different options for getting tested.
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  So,
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  a lot of times when you are diagnosed with cancer,
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  you'll have a biopsy of your cancer and to obtain a piece of tissue.
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  So,
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  uh you can have that piece of tissue sent right away to get the testing.
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  Uh Sometimes you can have another procedure to get another piece of tissue to test that piece of tissue or if there's no cancer that's really accessible and can be biopsied.
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  We now have blood tests.
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  Um What?
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  And those can be done instead,
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  is there a preferable test or does it depend on the individual and the type of cancer?
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  It depends on the person.
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  It depends on the,
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  where the cancer is located.
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  So all of those are certainly acceptable options.
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  So what happens after someone gets their cancer tested for mutations?
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  Well,
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  a a very long report comes back,
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  usually there are about 50 pages.
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  Oh,
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  wow.
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  And on that report,
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  it will say all the mutations that are,
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  are in the cancer and potential options for what to do about them.
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  So let's talk a little bit more about the mutation targeted treatments.
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  How are they better than the older treatments that you referenced at the beginning?
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  Yeah.
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  So one really important thing to keep in mind is that the mutations that cause cancer are usually only in the cancer,
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  they're not near other cells and you don't pass them on to your Children.
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  And so the new drugs that we have work specifically on those mutations,
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  and that means that the drug only works in the cancer.
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  And so it works better,
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  but it doesn't work outside of the cancer.
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  So there's no off target or adverse effects are fewer.
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  So are side effects similar between the treatments between the newer treatments and older treatments.
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  No of the side effects are actually much less.
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  Um These are usually oral drugs that you take on a day to day basis.
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  And like I mentioned,
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  since they only work on the mutations and the mutations are only in the cancer,
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  they don't have adverse effects outside of the cancer or they have much fewer.
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  So that's I I would say fairly significant progress.
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  Can you tell us what Marquee Cancer Center is doing to improve testing and the use of targeted therapies in Kentucky?
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  So the Marquee Cancer Center has set up a molecular tumor board.
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  Uh like I mentioned,
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  those reports can be sometimes 50 pages long and kind of overwhelming to read.
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  So Mary has put together an expert team at interpreting these tests.
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  And so any patient in Kentucky who has next generation sequencing test can ask their doctor in their community to have that sent to Mary for for evaluation and So uh our tumor board is made up of medical oncologists.
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  So the doctors who take care of chemotherapy,
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  administration,
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  basic scientists,
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  genetics,
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  counselors,
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  pharmacists,
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  and we all get together,
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  read through the reports,
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  interpret them and can make a re a treatment recommendation back to the treating position.
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  So it's not even really necessarily something that someone would have to come to Lexington for that,
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  it can all be done through their,
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  their personal phys physician and the board to get the recommendation,
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  but they can be treated locally.
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  That's exactly right.
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  And I should also say it's,
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  it's free of charge to the patient and to their physician.
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  Excellent.
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  So for our listeners that may be interested in more information,
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  I wanted to point out that co lesser has provided a um web link with more information from the Marquee Cancer Center on the Molecular Tumor board.
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  So if that is something of interest,
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  please check out the show notes.
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  And um Doctor Cole,
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  I want to thank you so much for joining us today and bringing awareness to the topic of precision medicine and how an individual may be able to access newer treatments.
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  Thank you so much for having me.
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