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Fingerprinting Cancer
A genetic assay helps doctors
determine specific treatment.
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1323039
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November 29 • 2007
hen Charlotte Stonestreet
about a cancer has enabled Beaumont
was diagnosed with
specialists to help design targeted
breast cancer last year for therapy, highly personalized for the
the second time, she thought it meant
individual patient.
that having a mastectomy was her
Prior to that, doctors had to use
only option.
their medical training and expertise
Stonestreet previously had breast
in a best-guess scenario when pre-
cancer in 1997 and knew that a recur-
senting treatment options to their
rence meant she most likely would
patients. There was little opportunity
lose her breast.
for targeted therapy except in a trial-
"I had it in my mind that that was
and-error way.
the way I had to go:' the 69-year-old
"In the past, most patients received
Dearborn woman says.
the same type of cancer therapy:'
She dreaded chemotherapy and
says Frank Vicini, M.D., chief of
losing her hair, and was
Photo by Elizabeth DeBeliso, Beaumont staff photographer
concerned that doctors
did not get all of the
previous cancer. Plus, her
mother died in 1987 after
breast cancer spread to
her stomach.
But relief was in store
for Stonestreet after
specialists at Beaumont
Hospital in Royal Oak did
a genetic analysis of her
second tumor. It was a
new cancer and unrelated Neal Goldstein holds the DNA "fingerprint" of a
to the one in 1997, which breast cancer.
meant Stonestreet was a
candidate for a lumpectomy followed
Oncology, Beaumont Cancer Institute.
by radiation.
"There was little variation because
"It meant a tremendous amount of
the molecular/genetic tools needed to
relief," Stonestreet says. "I said `Oh, I
help determine how to best treat their
can do this
specific cancer were not available."
The technology that brought
The information gleaned from the
encouraging news to Stonestreet
assay makes it possible to use fewer
— molecular clonality assay — has
drugs, resulting in fewer undesirable
been in use since the early 1980s for
side effects. It increases the chances
laboratory research. Beaumont doc-
for survival by gearing therapy to the
tors adopted it a year ago for clini-
characteristics of the cancer.
cal use, under the direction of Neal
In the long run, it can reduce
S. Goldstein, M.D., director of the
healthcare costs by telling whether no
Molecular Oncology and Advanced
treatment is indicated and by making
Diagnostics Laboratory.
smarter use of cancer fighters — che-
The assay looks at the individual
motherapy, radiation and surgery.
characteristics of cancer on the
"This technology allows us for the
molecular level.
first time to custom fit therapy for
With the assay, doctors get a reli-
each patient:' says Goldstein. "By iden-
able and accurate DNA "fingerprint"
tifying very specific characteristics
of cancer. The fingerprint gives cru-
of each cancer, we can determine the
cial information about how rapidly
best strategy to help control it."
the cancer might spread and what
The test can be used for cancer of
chemotherapy drugs are most effec-
the brain, lungs, uterus and ovaries, in
tive against it, in addition to telling
addition to breast cancer.
whether two or more tumors are
Beaumont started using the test on
related or not.
all women with a breast cancer diag-
Knowing these critical details
nosis on Sept. 1. —1