Rationale for the Personalised Cancer Medicine Program at Karolinska Institutet
Treatment decisions for individual cancer patients are based on experiences drawn from average responses in large patient cohorts and in absence of solid predictive biomarkers. However, remarkable research advances in recent years, validated in clinical trials, have dramatically improved our understanding of disease mechanisms and of the consequences of therapeutic interventions. Based on the new discoveries we can now envisage a more effective approach to the diagnosis and treatment of cancer patients, improvements achievable through personalised medicine.
The new prospects include novel ways to elucidate key aberrant signalling pathways in tumours of individual patients and novel ways to subsequently select the appropriate therapeutic regimen in each single case. This targeted approach will increase the therapeutic efficacy by providing the right treatment to the right patient at the right time. As a benefit unnecessary treatment regimes can be avoided in patients where biomarkers show that it will not work. This targeted approach will also reduce unwanted and often serious drug toxicity, by identifying patients who should not be given a particular drug on the basis of predictive biomarkers.
The concept of personalised cancer medicine is already trickling into the awareness of leading physicians and has started to influence the medical management of selected groups of patients at major academic cancer centres, including the Karolinska University Hospital. However, the necessary developments are extremely multi-faceted, while the time that separates experimental discoveries from their potential application in the clinic becomes shorter and shorter. The rapid development presents an overwhelming challenge to “traditional” clinical departments. Furthermore, the implementation of new knowledge into personalised cancer care demands the establishment of intense and far-reaching collaborations between clinicians and experts in other fields such as the various “–omics” areas, biostatistics and bioinformatics.
A new organisation is needed to efficiently translate the latest scientific advances into a concrete improvement of our capacity to provide optimal cancer care and ultimately conquer cancer. The creation of the Personalised Cancer Medicine (PCM) program at Karolinska Institutet serves such purpose. Its objective is to provide a focused effort towards the development and implementation of personalised cancer medicine in Stockholm and in Sweden.
The PCM-program will operate at different levels by:
- Bringing together cancer specialists working in different areas to achieve a coherent application of new diagnostic and therapeutic tools.
- Supporting, initiating and running translational research projects and clinical trials focused on personalised cancer medicine.
- Developing the necessary tools for the rapid translation of new knowledge into clinical practice.