Thanks to a $10 million anonymous pledge to the Rutgers University Foundation, two prominent institutes at Rutgers will collaborate to develop "precision" therapies for curing cancer.
In a clinical genomics laboratory at Rutgers Human Genetics Institute of New Jersey, high-end machines hum with the potential to rapidly advance the fight against cancer. The lab is part of RUCDR Infinite Biologics at Rutgers, which, along with the Rutgers Cancer Institute of New Jersey, is benefiting from a recent $10 million anonymous pledge to the Rutgers University Foundation. RUCDR is the world’s largest university-based repository specializing in genomics—the branch of molecular biology focusing on large numbers of genes and their functions. With more than 12 million stored biological samples categorized by clinical, genetic, and demographic information at their fingertips, scientists here work to pinpoint the genetic causes of complex diseases.
Just a couple of miles away from the facility, in a busy clinic on the first floor of the Cancer Institute, sit patients whose prognosis may depend on the findings of the RUCDR laboratory. Some have rare cancers with no known treatments; others have malignancies that don’t respond, or have stopped responding, to available therapies. Some are children with cancers that resist all standard drugs.
Upstairs there’s a weekly meeting in progress of the Molecular Tumor Board, led by Lorna Rodriguez, director of precision medicine at the Cancer Institute and professor of obstetrics, gynecology, and reproductive sciences at Rutgers Robert Wood Johnson Medical School (RWJMS). Many of the members are Cancer Institute oncologists noted in their fields. Others have expertise in genetics, pathology, basic science, and systems biology, which is a new field that looks at the interaction of the many parts of a complex living network such as the human body. This multidisciplinary team pools its knowledge and ideas in order to devise more effective approaches to hard-to-treat malignancies. The novel tool with which members are working is a focused genomic analysis of each individual cancer, something not offered to most patients.
The $10 million pledge—part of the largest fundraising year in Rutgers history and supporting Our Rutgers, Our Future, a $1 billion campaign launched in 2010—will support the collaboration of Rutgers Cancer Institute of New Jersey and RUCDR in order to give these patients a fighting chance. The goal is to provide “targeted,” or “precision,” therapy, which substitutes for often-toxic drug treatments that do not work for that particular cancer and pinpoints treatments that do, based on the actual genetic mutations driving the cancer. The two groups already have a history of effective partnership, but the integration of Rutgers and most of the former University of Medicine and Dentistry of New Jersey has opened novel avenues for collaboration. Together, they will work to ensure New Jersey’s leadership in this potentially game-changing approach to beating cancer.
“No two cancers or two people are exactly the same,” says Robert DiPaola, an oncologist who is also the director of Rutgers Cancer Institute. “Collaborating with the genomics laboratory will allow us to identify the drivers that make each tumor cancerous and then target therapies to these abnormalities.”
Although just a short time ago cancer was described primarily by its site of origin and stage, many cancers are currently diagnosed based on the molecular biology. For instance, it is now known that there may be more than five different types of breast cancer. “Precision medicine means precise to the biology of the particular tumor,” explains DiPaola.
“We’re looking at the genetics of cancer, not the tissue of origin,” concurs Jay Tischfield, the Duncan and Nancy MacMillan Distinguished Professor of Genetics at the School of Arts and Sciences who heads up RUCDR. “We analyze tumors in a more detailed way and pay attention to subtypes of a specific cancer.”
Relying on RUCDR’s highly sophisticated technology, the Cancer Institute of New Jersey hopes to offer genomic analysis to all patients within several years. In the meantime, the Cancer Institute is applying genomic analysis to rare or resistant malignancies, including those striking children, a specialty that is rare itself.
The Rutgers collaboration will certainly make a difference to patients. While the Cancer Institute already offers more than 250 clinical trials of new treatments, DiPaola says the menu of trials will evolve, thereby expanding what physicians there can offer. “If a cancer is treated and then comes back, we can determine if this recurrent cancer has acquired new genomic alterations that contributed to treatment resistance and use that data to find or devise therapies that target the changes. Resistant tumors often have a set of genetic changes that molecular analysis uncovers,” he says.
“This is a unique opportunity to apply research to patient care. We develop technologies and apply them clinically, allowing the team to move very quickly and very specifically,” says Andrew Brooks, a molecular scientist who serves as chief operating officer of RUCDR. “We will be able to set the standards that others will follow.”
The gift also supports the expansion of a genomic analysis clinical trial—in progress at the Cancer Institute—addressing patients with rare and poor-prognosis cancers. Shridar Ganesan is the oncologist-researcher who heads up the clinical trial and is also associate director for translational science at the Cancer Institute and an associate professor of medicine and pharmacology at RWJMS.
“Genomic analysis of tumors is available to all patients in this trial,” Ganesan says. “The tumor board uses this data to pinpoint new therapies.”
For example, HER2 is a breast cancer mutation that sometimes shows up in other tumors. “If specific HER2 mutations are found in a lung tumor, for instance, this raises the possibility that an anti-HER2 drug already developed for certain breast tumors may also work for this lung cancer,” he says. Fortunately, sometimes it does.
“These are the early days of this new approach,” Ganesan says. He foresees that specialists will become more skilled at deciphering the enormous quantity of new data and subsequently matching cancer mutations with specific, targeted therapies. Over the next few years, he thinks that this approach will translate into more effective and less toxic treatment approaches that will improve the outlook for cancer patients.
The $10 million gift will also support the recruitment of new faculty to help prepare the next generation of geneticists and systems biologists. “The gift will help us develop a whole new breed of researchers who will provide unique services for New Jersey,” says Linda Brzustowicz, chair of and professor in the Department of Genetics. As the research gains momentum, it will translate into more and better drugs to undermine difficult-to-treat cancers. And that will be a giant step forward for specialists at National Cancer Institute-designated cancer centers, like Rutgers Cancer Institute of New Jersey, and their patients. •