No longer one-size-fits-all: How your DNA informs cancer treatment

This paid piece is sponsored by Avera Health.

For patients with ovarian cancer and other types of cancer, there are two avenues of testing that involve a close look at your DNA – that hereditary helix found in each human cell that contains each person’s individual genetic code.

“In the past, cancer care has been ‘one size fits all,’” said Dr. David Starks, Avera Medical Group gynecologic oncologist. “That’s why we would see an amazing response to treatment in one patient and no response at all in another patient.”

To date, genetic and genomic testing has been more of a blanket approach, said Dr. Luis Rojas, with Avera Medical Group Gynecologic Oncology at Avera Cancer Institute. “As this science evolves, we’ll discover more targets and genetic sites on the tumor to explore for effective therapy.”

Some gynecologic cancers, like ovarian, go undetected until they are in the later stages of the disease. The Pap test only screens for cervical cancer, and otherwise, there isn’t a screening test for ovarian or uterine cancer.

That’s why Starks and Rojas have emphasized research ever since joining Avera. Genomics or precision oncology is another important component to find the best treatments for patients who may have advanced cancer.

“We’ve had patients who were previously running out of options for successful treatment have complete responses, with no evidence of disease and living way beyond the life expectancy for the extent of their disease,” Starks said.

What is genetic testing?

One avenue of testing is germline DNA testing, also known as genetic testing. This looks for inherited mutations in your DNA that have been present since birth. At Avera, this type of testing is coupled with genetic counseling. A genetic counselor can help you understand your family history, what genetic testing looks for and whether your family members might benefit from genetic testing.

Genetic testing can find inherited predispositions to certain types of cancers. The BRCA 1 and 2 mutations increase someone’s risk for ovarian, breast and other cancers. Other inherited mutations can cause Lynch syndrome, which can lead to colon, ovarian and other cancers.

Genetic testing and counseling can help you understand if you have risk for other types of cancers. They also can inform treatment. If someone has a BRCA mutation, she might benefit from an emerging class of drugs known as PARP inhibitors. PARP inhibitors keep cancers from growing by blocking their ability to repair DNA, ultimately killing off cancer cells.

What is genomic sequencing?

Genomic sequencing involves sequencing your normal cell DNA and the DNA of the tumor cells, looking for mutations that have occurred. This type of testing can help inform treatment and predict a patient’s response to a type of therapy, like PARP inhibitors, which are effective for certain patients but not a “magic bullet” for all types of ovarian cancer.

Starks and Rojas are at the forefront of research on PARP inhibitors. In fact, Avera was the first U.S. site to take part in an international study for ovarian cancer patients.

“Someday, we hope to be able to tell patients that based on your genomic sequencing, here is your personalized treatment package,” Starks said. “We’re not at that level yet, but we’re closer than ever before, and this is where cancer care is heading. Right now, we’re using genomic information to our best possible advantage to help patients experience the best possible outcomes.”

Lean more about innovation at Avera at Avera.org/Balance.