For decades, jobs for the prevention, diagnosis and treatment of cancer have not stopped proliferating. Every day new advances are known in oncology, where technological innovation plays a fundamental role in improving techniques and procedures, allowing tumor knowledge to be tumors and, therefore, to adapt treatments to each oncological patient lengthening life expectancy. Added to these technologies, and with the development of precision medicine, in the opinion of Mónica Farm, Scientific Secretary of the Spanish Society of Medical Oncology (SEOM) and specialist at the Clinical Hospital San Carlos, in Madrid, “It is essential to highlight the Importance of molecular diagnosis, which covers different methods, from the most traditional immunohistochemical staining tests, to new DNA sequencing techniques such as genomic sequencing panels. ” These panels, as detailed farm, “identify different alterations in the tumor cell DNA that can contribute to its growth and for those that may exist specific treatments with an impact on survival and a decrease in side effects.”
The molecular diagnosis allows to use minimally invasive techniques to detect very precisely and in very precooked stages cancer.
It is about identifying and analyzing biological markers (biomarkers) that can be measured objectively and be evaluated as an indicator of an abnormal biological process, state of a disease or response to treatment.
Thus, thanks to it, it has been possible to “change the natural history of certain subtypes of lung cancer, breast, colon or melanoma, among others, significantly improving the prognosis and survival of these patients,” says the scientific secretary of the
SEOM.
However, and despite the advances, she is aware that there is a long way to go, because there are still “orphaned in biomarker identification” tumors.
The Spanish Spanish company, of the Pharmamar group, is one of the leading companies dedicated to molecular diagnosis.
Its work focuses on designing kits – currently has two for colorectal cancer, three for lung and one for melanoma – which detect these oncological biomarkers and allow you to choose the most appropriate treatment to each patient.
It is what is called a diagnosis of accompaniment.
“There are a number of oncological medications they need, before being administered, that a diagnostic test is made to see if the patient has a genetic mutation and will answer or not to that treatment,” explains Rosario Cospedal, General Director of Genomica
.
If that test is not performed, the patient is running that the patient does not respond to the medication “because he has a mutation in his DNA and, in addition, has numerous side effects; and on the contrary, because there are medications that would not respond if that mutation
concrete “.
But what is molecular diagnosis?
“Explain it is very easy because it is a PCR and now everyone knows what it is for the Covid,” says Genomica Director General.
It is about extracting a sample from the patient, “which normally is usually a biopsy or, in the case of what we call liquid biopsy, blood or plasma. From there you get the patient’s DNA, amplifies it by PCR, achieving millions of copies of
He, and detects if that patient has a mutation; otherwise it would be impossible. ”
In this extraction of the DNA of the oncological patient and the gene analysis is where the University of Navarra (CUN) clinic focuses on its efforts, beyond advanced image techniques “such as resonance guided biopsy, applied in prostate cancer , or all the technology related to nuclear medicine, fundamentally with the PET, which is of the highest resolution, “says Antonio González, director of Medical Oncology of the CUN in Madrid. He himself explains that the most innovative they have incorporated in cancer approach “is to be able to analyze 500 genes in tumors of patients who are diagnosed or those who come to consult the clinic, which allows us to make a screening Molecular tumors from the beginning “, with which treatment and forecast are favored. “We already had a one hundred and peak genes platform and now we take the jump to more than 500, putting us at the level of others that there is in the USA as the Foundation Medicine. Be able to diagnose patients very well and give them what they need is the engine of our activity, “he says the Director of Medical Oncology of the CUN in Madrid.
In general, this analysis has application in almost all tumors, “but there are some where it has an extreme application, such as lung cancer where more gene mutations have been found that are associated with a treatment. It is probably the disease that is most
Benefit, although also colon and straight cancer has a very high benefit. ”
Having a molecular target that has a treatment causes the prognosis of tumors and, therefore, survival expectations of patients improve considerably.
“A paradigm is ovarian cancer with BRCA mutations. Today, patients with this type of cancer have more survival because we have specific medications against this alteration, which are the PARP inhibitors. And this has made that
Survival duplicates. If in ovarian cancer, stages III and IV which is normal for diagnosis, five-year survival without relapse was 20% or 25%, now we have achieved half of patients within five years
Recale. There is still the other half, but we have duplicated those who are without relapse. It is an example of how the natural history of these patients has changed, “concludes González.
