Navigating the Latest Research in Integrative Oncology

Amy Loschert, ND, FABNO • May 01, 2019

Utilizing advances in genetics and human genome interpretation has recently been a hot topic in the area of cancer care. The following tests are available to patients now and can be utilized for diverse purposes.

Test Type #1 - Multigene panels used to predict prognosis and treatment response in breast cancer

a. OncoType DX:
Who benefits?
Women diagnosed with ER-positive breast cancer who have had surgery to remove the primary tumor whether or not they have positive lymph nodes. Some women at this point may still benefit from chemotherapy due to the high likelihood of recurrence based on the aggressiveness of their particular tumor, which is discovered once the tissue is analyzed after surgery.

How does it work?
Once a sample of tumor tissue is taken and analyzed for specific cancer genes, it is given a Recurrence Score (RS) from 1-100. This is used to predict the likelihood that a woman will respond to chemotherapy. Patients with a “high” RS (>25) showed benefit from chemotherapy and experienced significantly fewer recurrences, while those with a “low” RS (<25) who received chemotherapy had a greater risk of a recurrence within 10 years. Results are based on women taking estrogen blocking agents across all trials.

b. Mammaprint:
Who benefits?
Women with early diagnosed (Stage 1 or 2) estrogen-positive or estrogennegative breast cancer who have had surgery (either lumpectomy or mastectomy) and are considering chemotherapy due to a potentially aggressive tumor.

How does it work?
Genes related to early cancer growth and recurrence risk were collected from women, assessed over 5 years and placed into two categories: “good prognosis” or “poor prognosis.” The 10-year survival likelihood was 95% versus 55% relatively in the two groups.

Test Type #2 - Gene Sequencing Technology used for detecting realtime changes in a cancer’s evolution that could predict the next most valuable treatment
Who benefits?
People who have a more advanced “solid tumor” type of cancer (lung, breast, colorectal, sarcoma, melanoma, ovarian, pancreatic, liver etc.) AND either a tumor biopsy is not an option, you are no longer responding to your latest drug regimen or there is progression of disease or metastasis.

What is it?
A blood sample to detect circulating tumor tissue DNA and its latest mutations, also known as a “liquid biopsy.” No invasive procedure is necessary.

How is it beneficial?
As a cancer grows and evolves, it looks different over time. This opens the door for other newer treatments like “targeted agents” (unlike systemic chemotherapy, so not as generally toxic) to be used with success at halting further progression of the cancer. This test looks to see which drugs match the specific mutations found and give recommendations as to what is available either on the market or in clinical trials.

Test Type #3 - Predictability of acquiring a genetic cancer
Some people are born with mutations in their DNA acquired from either parent, which puts them at higher risk for developing certain diseases.

For example, the average person has about a 6% chance of getting colorectal cancer. However, if you have inherited a “mismatch repair” gene mutation, your likelihood of acquiring colorectal cancer rises to 80%, and your chances of acquiring other types of cancer become much higher than the general population.1 According to the Office of Disease Prevention and Health Promotion, screening interventions could potentially reduce the risk of colorectal cancer among men and women by about 60%.2

What is it?
Proprietary gene sequencing technology is used on blood samples of healthy people to detect DNA mutations on targeted genes most found to be associated with hereditary cancers. The same technology can target genes known to have particular mutations associated with hereditary heart conditions or hereditary familial cholesterol disease.

Who benefits?
1) Family members of those with a known genetic mutation that led to their cancer, 2) family members of someone with cancer and 3) anyone who is curious if they have an inherited mutation that puts them at greater risk of developing cancer in the future.

How is it beneficial?
1. If a person has a hereditary cancer this often leads to a different treatment plan and/or prognosis. So, if one has just been diagnosed with a cancer it is good to know if it is from an inherited mutation or not.
2. For family members of those with hereditary diseases. Testing allows one to focus on prevention, as well as identify those who should receive early diagnostic testing/imaging knowing they are at far higher risk than the rest of the population.

Dr. Amy Loschert, ND, FABNO, is a naturopathic doctor in Fife, Washington, and has been practicing for 16 years. She graduated from Southwest College of Naturopathic Medicine and Health Sciences in 2003 and specializes in naturopathy and oncology.

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