Chirag Patil, MD
Cedars-Sinai Precision Medicine Initiative Against Brain Cancer
Empowering Personalized Cancer Care through Precision Science
The “one mutation-one drug” strategy for treating brain cancer, and for the most part other complex solid cancers, has not worked. One of the main factors for this repeated failure is a sort of “tunnel vision” – a fixation on blocking only one or two deregulated or mutated cancer-signaling pathways. Due to the complexities of such a massive task, a more holistic picture of all relevant cancer signaling pathways has not yet been built. Additionally, today’s standard-of-care, which includes surgical removal, radiation therapy, and chemotherapy, has only modest benefits. For example, patients with glioblastoma multiforme (GBM), the most aggressive and common type of brain cancer, live on average 15 months after diagnosis.
The Cedars-Sinai Precision Medicine Initiative for Brain Cancer aims to change this. We developed our precision science strategy through an intense collaboration between academia and industry (Cellworks Group Inc.). We are bringing together individuals with diverse expertise in cancer biology, software engineering, mathematics, and pharmacology to holistically model most of the known cancer cell-signaling pathways. To help illustrate the strategy, think of the tumor as the Death Star from “Star Wars.” You cannot mount an attack on one small, perceived weakness on its surface (i.e., a single mutation on a cancer cell). Rather, you need a multitude of talented spies that infiltrate and bring back the blueprint of the Death Star’s complex architecture. Only then is a coordinated and precise attack possible.
Transcending this “Star Wars” fantasy, we have made considerable progress in our strategy in a short amount of time. An in-silico drug matching algorithm is now fully functional; it identifies novel targeted drug cocktail custom tailored to kill each patient’s unique tumor. We are currently evaluating the first five patient samples with our precision medicine strategy and will have data on almost 30 brain cancer patients in less than six months. Moreover, we are developing an innovative randomized clinical trial, not to compare one drug to another, but rather to compare our Precision Medicine Treatment Algorithm to a current standard treatment regimen. Fortunately, we are not the only forward-thinking program of this kind. At the University of Florida, Dr. Christopher Cogle has started a clinical trial that is assessing the merit of this precision medicine strategy in patients with multiple myeloma, which is a blood cancer. Personalized cancer care powered by precision science may seem futuristic, but we are demonstrating that the future can be now.