OK, I admit it. When I was a kid I was into Star Trek (even had a picture of the starship Enterprise on my wall). Not the Star Trek movies or the newfangled “Next Generation” or “Deep Space 9” series, but the original series first broadcast in the 1960s. I was fascinated by the transporters, flip-top communicators, and medical “tricorder” that was waved over the patient by Doctor McCoy (called “Bones” by the future Iowan Captain Kirk) to make a medical diagnosis in seconds.
Fast forward 45 years … I am still waiting on the transporters, but Star Trek’s flip-top communicators seem quaint compared to today’s smart phones. How about the medical tricorder? We have CT, MRI and PET scanners that were not on the starship Enterprise radar screen 45 years ago. This week, at the University of Iowa, we rolled out another type of medical test that goes even further into the “final frontier” of molecular medicine.
Starting October 24, the University of Iowa Department of Pathology will implement a revolutionary new DNA sequencing test for cancer. This is the first clinically validated massively parallel DNA sequencing test (coincidentally known as ‘next generation’ sequencing) to be offered in Iowa. It allows us to evaluate 50 cancer-related genes and over 2,800 different mutations listed in the “COSMIC” catalogue. And no, I am not getting my Star Trek and cancer genetics themes confused – COSMIC stands for Catalogue of Somatic Mutations in Cancer. Additional genes and mutations will be added as our cancer genetics research takes us “where no man has gone before” (yes, I am getting a bit carried away with the Star Trek metaphor, but bear with me) as we continue to update and expand the COSMIC catalogue. For more information on the test, you can call my colleagues in the UI Molecular Pathology Laboratory at 319-384-9566.
This testing will provide valuable information about the genetic changes in cancer cells obtained from individual patients—information that will be used by Holden cancer doctors to determine the cancer type, predict the behavior of the cancer (slow or fast-growing, likelihood of spread or recurrence, etc), and predict the potential response to existing and emerging cancer treatments. It will allow us to look at all these genes at once, saving valuable time and cost and enhancing our understanding of how multiple gene mutations in a single cancer interact. It will also allow us to detect mutations in samples that contain a mixture of cancer and normal cells. In a parallel effort, we are part of a research team through the National Cancer Institute exploring cancer genetics in hundreds of samples using a technology known as “deep sequencing”.
Our ability to sequence multiple genes for cancer patients is a historic leap forward for molecular medicine, yet there is much more work to be done. We are just learning how to apply advances in molecular medicine to care for cancer patients. Progress over the next few years is going to happen incredibly fast (dare I say – at “warp speed”) as we learn more about how to use this information to help our patients.
With these new tools and additional research, we look forward to being able to quote Mr. Spock more often when talking to our patients and say, “Live long and prosper.”