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Timothy Greiner, M.D. |
The test allows oncologists to effectively target therapy, which saves patients precious time and money.
The test checks tumors for a mutation in the gene, KRAS (pronounced K-ras), said Timothy Greiner, M.D., professor of pathology/microbiology at UNMC and medical director of the Molecular Diagnostics Laboratory at The Nebraska Medical Center.
“If the mutation exists, oncologists know which treatment to use,” Dr. Greiner said. “This is an evolutionary change in the way we manage cancer. With this test, we can predict how patients’ cancers may respond to treatment.”
Colorectal cancer is one of the most commonly diagnosed cancers and the second leading cancer killer in the United States. But, if everyone aged 50 or older had regular screening tests, as many as 60 percent of deaths from colorectal cancer could be prevented.
KRAS is an oncogene, a certain type of protein that’s part of a signal chain found in normal cells. When the chain is switched ‘on,’ the cell divides or grows; when it’s switched ‘off,’ growth stops. But, when KRAS mutates, the chain stays on and activates a signal for indefinite cell growth — or cancer.
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“The KRAS test is an example of the new era of pharmacogenetics or personalized molecular medicine testing, where an individual’s tumor is tested to determine the best care for the patient,” Dr. Greiner said.
Established in 1996, the Molecular Diagnostics Laboratory performs more than 28,000 tests per year and is the fastest growing division in the medical center’s pathology laboratories. As part of personalized medicine, the lab tests a patient’s sensitivity to certain drugs or identifies genetic targets that allow for customized treatment.
KRAS is one example of how molecular tests are starting to impact patient care. Other examples include determination of patient response to:
- Coumadin, a blood thinner medication;
- Tegretol, an anti-seizure medicine; and
- Abicavir, an anti-HIV medication.
In addition to identifying sensitivity to drugs, the molecular diagnostics laboratory measures the number of copies of the abnormal chromosome translocation called BCR-ABL in chronic myelogenous leukemia. This is important to evaluate the effectiveness of GLEEVEC therapy in patients with this leukemia.
“We think this is just the beginning of what patients and doctors will benefit from in the coming years,” Dr. Greiner said.