Scientists believe they are close to rolling out a radical technique that allows them to develop extremely personalised cancer treatments, that will substantially increase life expectancy.
They think within five to ten years they will be able to sequence the DNA of tumours in every cancer patient – allowing doctors to deliver a highly tailored treatment. The work, due to start at the £3million Tumour Profiling Unit in London this year, is expected to pave the way for radical forms of diagnosis, surveillance and therapy.
Doctors think closely examining the genetic make-up of every individual tumour will revolutionise the effectiveness of the treatments at their disposal.
They say the technique could substantially increase life expectancy, allowing terminally-ill patients to live for a decade or more in good health.
For example, one patient at the Royal Marsden in Chelsea has been taking the breast cancer drug Herceptin for a decade, although this is considered an exceptional case.
Professor Alan Ashworth, chief executive of the Institute of Cancer Research, which is running the project, said: ‘None of this is science fiction. 'One would think in five or ten years this will be absolutely routine practice for every cancer patient, and that’s what we’re aiming to bring about.
‘We should be aspiring to cure cancer, but for people with advanced disease, it will be a question of managing them better so they survive for much longer – for many years.
‘Cancer often appears in people who are old, and if we can keep them alive long enough for them to die of something else, then we are turning cancer into a chronic disease.’
Genetic profiling of cancer is already being investigated at several laboratories around the world, but the new unit will pioneer its use, he said.
For example, patients with advanced breast cancer are tested to determine if their tumours have a particular type of the HER2 gene, responsible for 20 per cent of cases.
Skin cancer patients with a particular type of melanoma may also be prescribed the life-prolonging drug Vemurafenib. Professor Ashworth's team will use the techniques to track cancers as they progress, mutate and develop resistance to drugs.
At the moment, tumour DNA has to be profile using an invasive biopsy. But the scientists now hope to develop a blood test to identify DNA floating around the body from tumours instead.
They hope the programme will shed light on currently intractable problems such as so-called ‘unknown primaries’ – cancers of unknown origin that account for one in 20 cancers.
It may also start to reshape the way trials of cancer treatments are conducted. Currently, all cancer drugs go through a process that ends with a big trial involving several thousand patients. Such trials are designed to look for small success rates across large population. But they often lead to drugs being marketed that only benefit a minority of the patients who take them.
For example, only one in ten women given chemotherapy for breast cancer actually responds to the treatment.
In future, big trials could be replaced by smaller studies providing much more meaningful results.
Each would recruit a few hundred patients whose genetic make-up is likely to suit the treatment being tested.
Professor Ashworth said: ‘Basically, the way we’re developing drugs for cancer is now failing big time. Certainly, the idea of developing old-fashioned chemotherapy is going out the window.
‘Let’s design the trials for success rather than failure.’
The research has been made possible by the rapid reduction in the cost of genetic sequencing.
It took a decade of work and around £2billion to produce the first draft of the human genome, or genetic code, in 2000.
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