If all the ways genes run amok to cause cancer were laid out in a dictionary, scientists would be able to decipher only a small part of the first page.
Hoping to change that, the government is set to begin a $100 million pilot project to unravel the genetic makeup of cancer, with the idea of speeding the discovery of culprits and treatments that today is largely a matter of scientific luck.
It’s an audacious project, said Dr. Francis Collins, the National Institutes of Health’s genetics chief, who was announcing formation of the Cancer Genome Project on Tuesday.
It’s far more complex than research that mapped the human genome, a molecular blueprint for our species. But the technology does exist to finally track down the genetic changes required to spark any of the 200 diseases we collectively call cancer — knowledge crucial to develop better treatments, Collins said.
“You remember when people were skeptical that we could determine the genome of just one individual,” said Collins, who helped direct that project. To map all the genes involved in cancer, “we’re talking about basically thousands of Human Genome Projects.”
But, “the time is right,” he added. “We have the opportunity, because of advances in technology, to really look at the global nature of what is wrong with the cancer cell in a way that frankly we could not have dreamed of even a few years ago.”
Disease's domino effect
Scientists have discovered numerous genes that play a role in cancer. Sometimes a single genetic mutation is enough to spark a tumor, sometimes it just makes people more vulnerable to the disease. Other changes mean the difference between a fast-growing killer or a less dangerous tumor, or determine whether a particular treatment is likely to work.
But developing cancer usually involves about a dozen critical genetic alterations — a domino effect — that differ by malignancy, and scientists have uncovered only a fraction of them, an NIH working group reported earlier this year.
“What makes cancer so hard in terms of really conquering the disease is its complexity,” explained Dr. Anna Barker of the National Cancer Institute. “There are myriad genetic changes that drive the processes that are cancer, and every one of those can be a little different from one human to another.”
A handful of so-called targeted drugs — Herceptin, Gleevec, Iressa, Tarceva — are proving remarkably effective at battling certain cancers in patients with specific faulty genes.
That’s only a small portion of patients. But those drugs show that “if you can find pivotal mutations, you can actually change clinical practice,” Barker said.
Under the Cancer Genome Project, researchers who now work independently will be able to share data in hopes of speeding such discoveries — not just of specific gene mutations, but of chromosome rearrangements, faulty on/off switches and other abnormalities.
Funded by the NCI and Collins’ National Human Genome Research Institute, it will begin as a three-year pilot project focusing on two or three still-to-be-chosen cancer types.