Reported in 2009, years of research created a test called the PAM50 Breast Cancer Intrinsic Classifier that sorts breast cancer into four subtypes. Each subtype responds differently to standard therapies, and knowing the subtype allows doctors to tailor treatment for each patient. Moving that laboratory work to the clinical space where it can help patients involved building a sophisticated lab at ARUP Laboratories, a University of Utah enterprise that is a national reference laboratory offering a wide range of medical tests.
“In 2010, we had to reinvent everything that had been done in the research setting at HCI,” says Philip Bernard, MD, HCI investigator and associate professor in the Department of Pathology at the University of Utah.
“It involved equipment to manufacture the test in-house and robotics to assure consistent reproduction of the technique so there aren’t variations between test batches,” says Bernard. “The informatics component required rewriting the software for examining 50 genes simultaneously and reporting the results so they can be easily interpreted.”
“Moving a discovery into the clinical space and offering it to patients is as big a job as the discovery itself, and a longer process,” says Bernard. “It’s usually not as glamorous.”
As for the future, Bernard expects that the PAM50 intrinsic classifier is only the beginning, because different mutations are associated with each subtype. “We hope to develop additional mutation testing that will allow even more customization of cancer therapies, finding specific combinations of drugs that match the combination of mutations in the tumor,” he says. “The new discoveries may turn out to be more important than the original.”
Back in the lab, HCI researchers Alana Welm and Bryan Welm are using the PAM50 intrinsic classifier to look at breast cancer in mouse models. They’re studying tumor development and performing screens for potential new treatment drugs. Here’s another instance where translational research travels a circular path from the lab to the clinic and back around to the lab for more research and more discovery.
In the meantime, Bernard is studying subtypes in other cancers. “I’ve been working on research identifying different biologies within lung cancer for at least five years,” he says. A paper on this research was recently published. “Now it’s ripe enough to start moving toward the clinic as well,” he adds.
Read the 2009 Annual Report story Making Breast Cancer Personal: New Test Identifies the Best Individualized Treatment.