Precision Medicine - Genomic Profiling

Recent advances in the science of genetics have demonstrated that doctors can more effectively treat many brain tumors by first analyzing their genetic characteristics. We have learned that this may be much more important than looking at tissue samples under a microscope, which has been the standard practice for over 100 years.

Particularly in malignant brain tumors, the prognosis and the best way to treat a particular tumor is much more dependent on the tumor’s genetic makeup rather than what the tumor is classified as based on the appearance of the tumor cells when viewed under a microscope.  Some tumors that look very benign will act like an aggressive cancer if they have certain genetic markers.  Others that look malignant can have a much more benign behavior if they have certain genetic characteristics.  

This discovery has important consequences for diagnosis and treatment decisions for every patient with a brain tumor.  This is a major advance in what is called Precision Medicine, in which brain tumor treatments are customized according to the genetic makeup of the each individual patient’s tumor. 

Specifically for primary brain tumors, tumors with one genetic profile, for instance, are relatively slow growers and responsive to drug treatment, making them good candidates for chemotherapy alone, rather than combined with radiation. Tumors in another category grow relatively slowly but are not as responsive to drugs, suggesting that combined therapy was best.  And tumors in a third category are aggressive, for which the prognosis is usually dim. But catching those tumors early will give families time to enroll in experimental trials, and will give patients, their families, and their doctors more specific guidance on which treatments and trials will be most suitable.

At the Kenneth R. Peak Brain and Pituitary Treatment Center at Houston Methodist, genetic profiling is performed on every primary brain tumor, and analyzed using several different techniques.  Not only are genetic changes assessed, but we then look at what these genes do and decide which treatments will specifically target the discovered genetic differences.  We offer this to all patient with brain tumors, and are optimistic that this Precision Medicine approach will improve outcome and quality of life for our patients.