How functional precision medicine could be the future of cancer care | Dr. Diana Azzam | TEDxMiami

Key Concepts

• Functional Precision Medicine
• Genomic Testing
• Standard of Care Treatments
• Personalized Treatment
• Drug Sensitivity Testing
• Cancer Cell Culture
• FDA-Approved Drugs
• Actionable Steps
• Remission
• Artificial Intelligence in Cancer Treatment

Introduction

Dr. Diana Azam, a cancer researcher at Florida International University, discusses the limitations of standard cancer treatments and introduces functional precision medicine as a more personalized approach. She highlights the need to move beyond "one-size-fits-all" solutions and tailor treatments to individual patients and their unique cancers.

The Problem with Standard Cancer Treatments

• Cancer is a leading cause of death in both adults and children.
• Despite advancements, one in three cancer patients still die from the disease.
• The healthcare system relies on "standard of care" treatments, which are designed to work for most people most of the time.
• Cancer is unique to each individual, and standard treatments often fail because they don't account for this variability.
• "Every cancer is unique. Every person is unique. And when standard treatments fail, we need better ways."

Functional Precision Medicine: A Personalized Approach

• Functional precision medicine involves taking a sample of a patient's cancer cells and testing them against hundreds of FDA-approved drugs to determine which ones are most effective.
• This approach focuses on finding out what actually works for the individual patient, rather than relying on averages.
• "Imagine if we can take a sample of your cancer, your actual cancer cells, and test them against hundreds of FDA approved drugs, not in theory, in real life, to find out what actually works for you. Not an average patient, you. That is the power and promise of functional precision medicine."

How Functional Precision Medicine Works

1. Tumor Sample Collection: A small sample of the patient's tumor is taken.
2. Cell Culture: The cancer cells are cultured outside the body in a lab environment that mimics their natural growth conditions.
3. Drug Exposure: The cultured cells are exposed to a wide panel of FDA-approved drugs, including both cancer and non-cancer drugs.
4. Response Observation: Researchers observe which drugs kill the cancer cells and which ones have no effect.
5. Personalized Treatment Plan: The results are used to create a personalized treatment plan tailored to the individual patient.

Functional Precision Medicine vs. Genomic Testing

• Genomic testing analyzes a patient's DNA to identify mutations and target them with specific drugs.
• While genomic testing is a powerful tool, it only tells part of the story.
• Many cancer patients, especially children, don't have mutations that can be targeted.
• Even when a mutation is found, the targeted drug doesn't always work.
• Functional precision medicine complements genomic testing by directly testing the effectiveness of drugs on the patient's cancer cells.
• "Instead of assuming which drugs might work, let's test and find out what actually works."

Logan's Story: A Case Study

• Logan was diagnosed with acute myeloid leukemia at age three.
• He underwent chemotherapy and a bone marrow transplant, which initially put him into remission.
• His cancer returned a year later, becoming more aggressive and resistant to treatment.
• Logan was enrolled in a functional precision medicine trial led by Dr. Azam.
• The trial identified a targeted drug that worked for his mutation, eliminated an unnecessary toxic chemotherapy medication, and removed steroids from his regimen because they were fueling cancer growth.
• Within 33 days, Logan achieved remission after a second bone marrow transplant.
• Three years later, Logan remains cancer-free.
• "We got our son back." - Logan's mother.

Data and Research Findings

• In the first clinical trial, children whose treatments were guided by functional precision medicine had an 83% better response rate than those treated by doctor's choice.
• The study was published in Nature Medicine and featured on the cover.
• Ongoing clinical trials in both children and adults continue to show promising results.
• With artificial intelligence and more data, researchers aim to predict effective treatments without needing a biopsy.

Why Functional Precision Medicine Isn't Standard of Care Yet

• More data is needed to validate and scale the approach.
• Increased adoption will lead to more learning and strengthen the case for making it the standard of care.
• "To truly make functional precision medicine the standard of care, we need to keep generating more data, validating it, scaling it because the more patients we help, the more we learn and the stronger the case becomes to make this the standard of care."

Call to Action

• Cancer patients should ask their doctors about functional precision medicine and advocate for it.
• Physicians should consider collaborating with functional precision medicine researchers.
• Policymakers should support initiatives that expand access to this technology.
• Individuals can support the cause by contributing to research and advocacy efforts.
• "If you're a cancer patient, ask your doctor about functional precision medicine. Advocate for it. If you're a physician, consider collaborating with a functional precision medicine researcher. If you're a policy maker, support initiatives that expand access to this technology."

Conclusion

Dr. Azam emphasizes the potential of functional precision medicine to revolutionize cancer treatment by providing personalized solutions that improve patient outcomes. She calls for increased awareness, collaboration, and support to make this approach the standard of care, ensuring that all patients have access to the most effective treatments possible. The goal is to move away from guessing and towards a future where cancer treatment is tailored to the individual, leading to more success stories like Logan's.