With an unprecedented level of community involvement, The Medical Foundation, Harper Cancer Research Institute (HCRI), Saint Joseph Regional Medical Center
and Beacon Health Systems are collaborating to bring personalized medicine using
the Sequenom MassARRAY technology to the Michiana area.
Through grants and allocation of funds from each facility, The Medical
Foundation will be able to provide mutational profiling for new cases of certain
cancers in the area. Approximately 650 patients who present at Saint Joseph
Regional Medical Center in Mishawaka and Plymouth, and Beacon Health Systems
including Memorial Hospital and Elkhart General Hospital, with new cases of
metastatic melanoma, lung cancer or colon cancer over the next two years will
take advantage of the latest technology available.
The MassArray analyzer is able to examine the DNA in a tumor by looking for
105 mutations in one reading. The 105 mutations have been identified by
researchers who have examined whether certain drug treatments benefit various
patients with these specific actionable mutations. This testing allows
pathologists and oncologists to spare patients the extreme toxicity associated
with treatment that may never kill their particular tumor.
“This hits the whole idea of patient centered care from many different ways
and it’s my hope that this will truly help patients who need this data to get
optimum care for their tumors,” said Medical Director of Molecular Pathology at
The Medical Foundation, Bobbie Sutton, M.D. “That’s the bottom line here, I’m
hoping that this will help change people’s lives for the better and help them
fight their disease,” she said.
For Medical Oncologist Dr. Robin Zon, the information provided by the
MassARRAY analyzer allows her to use targeted therapies for patients. Before the
arrival of the Sequenom MassArray instrument, patients were mostly treated with
a standard drug therapy that may or may not attack the cancerous mutations in
the patient. Having tests performed to pinpoint the mutations was very expensive
and hard to obtain locally with some tests costing patients several thousands of
dollars.
“From a patient perspective, what this means is that if we can discover that
a particular patient’s cancer has the right signature to be treated for a
particularly targeted therapy, as opposed to chemotherapy, where you don’t know
if it is going to work or not, with targeted therapy there is an increased, but
not 100% guarantee that the therapy we are offering based on this information is
going to be useful,” said Zon.
Zon encourages patients who are eligible for this type of testing and other
clinical trials to become involved if possible because these types of trials are
often instrumental in helping with further research endeavors.
“It’s all very much a learning curve so I think we’ve made advances for some
actionable targets for lung, melanoma and colon, which is why those are the
three that are being targeted with this new technology,” said Zon.
Dr. Sutton and Dr. Robert Tomec, President of The Medical Foundation, in
accordance with recommendations from The College of American Pathologists (CAP)
determined that concentrating on actionable mutations in metastatic melanoma,
adenocarcinoma of the lung and colon cancer would be most beneficial to the
community.
According to Dr. M. Sharon Stack, who applied for the Walther Cancer
Foundation Grant on behalf of the Harper Cancer Research Institute and The
Medical Foundation, lung cancer is the leading cause of cancer deaths in Indiana
claiming over 4,000 lives annually. She also noted that colon cancer is the
third most diagnosed cancer in the state. Additionally, in a study released in
2012, cancer rates in Northern Indiana, particularly in St. Joseph County, were
significantly higher than the state average. These are just a few of the reasons
her staff would like to begin researching these three types of cancers in
patients at our local hospitals.
The Medical Foundation has agreed to provide testing during this pilot
program at cost and Beacon Health Systems and Saint Joseph Regional Medical
Center have each contributed funds to offset costs so patients can receive this
state-of-the-art technology free of charge. Currently, many insurance companies
don’t reimburse charges for certain types of molecular testing.
“We agreed to participate in the personalized testing fund for patients who
have that need because it fits in the mission of Saint Joseph Regional Medical
Center. Part of what is embedded in St. Joe’s legacy and who we are in the
community is to care for the poor and the underserved and there’s a lot of
changes in the healthcare system, many for the good, but at the same time, it’s
very challenging when you’re uninsured or underinsured or there’s testing that’s
available for patients who just don’t have the wherewithal to have the testing,”
said Christopher Karam, Chief Operating Officer at St. Joseph Regional Medical
Center.
Greg Losasso, President of Elkhart General Hospital which is a part of Beacon
Health Systems, agrees with Karam that both organizations have support and care
of their patients as their number one priority when venturing into this
partnership with HCRI and The Medical Foundation.
“We’ve always been committed to doing research and partnering with The
Medical Foundation and Notre Dame, it gives us the breadth within the community
to do things locally and really try and bring our care to a higher level.
That’s part of our ongoing commitment and that’s why it was so easy for us to
get involved in this project,” said Losasso. “Through research we make
improvements not just in our local communities, but around the country and the
world,” he said.
As for the future of this type of testing or use of the Sequenom MassARRAY
analyzer following the two year grant, the possibilities are endless according
to Tomec, Sutton and Andy Bullock, Ph.D., M.B.A, Associate Director at the
Harper Cancer Research Institute.
For the team at HCRI, each patient who benefits from the mutational profiling
will have a personal profile built which researchers will then analyze to see if
certain geographical, lifestyle or other correlations can be drawn between
patients.
Also, The Medical Foundation will work closely with HCRI to analyze DNA from
paraffin blocks that have been stored at the Foundation for several decades.
The paraffin blocks contain small cancerous tumors which may contain several
samples from certain patients over time. When the DNA is run on the analyzer,
researchers will be able to examine mutation profile changes over time.
Researchers are hoping to learn more about how treatment may have affected the
mutations over time.
As for Sutton, she believes work may continue with tumors, but there is also
the possibility of creating better testing for hemoglobin electrophoresis among
other DNA based projects.
“I anticipate going forward, that this analyzer will still be the workhorse
churning out data on a regular basis. Maybe not on tumors, but there are other
options, other topics that I want to aim at just because I think it’s good
medicine,” said Sutton.
Tomec believes there are numerous possibilities, as well. “As technology
changes I think there will still be a role for this MassARRAY technology not
only in solid tumor testing but in other areas such as pharmacogenetics and
tissue identification, so the value of the technology will be ongoing,” he
said.
The collaboration and partnerships with the hospitals, HCRI and The Medical
Foundation continues to grow because, “we can all unite by putting the community
and our patients first, because we all have that as a priority, which is a great
example of why we should be participating and working together,” said Karam.
“We all have that common goal, to take care of the people in the Michiana
community,” he said.
