“The essence of precision medicine, in particular precision oncology, is to make cancer management more precise based on genomic mapping and molecular characterization of the unique tumors for each patient,” says Dr. Wei Zhang. “The cancer management that needs to be precision include diagnosis, prognosis, treatment plan, treatment monitoring, and genetic counseling.”
Precision medicine, and by extension, oncology, is the buzzword of the moment among doctors and researchers, and it is more than just spin or a fad. With regards to cancer, and as our understanding of the disease has increased, the idea of a one-drug-cures-all panacea is now widely considered obsolete (however much of a holy grail such would be). Cancer, even the same type, varies at a genetic level from patient to patient. The therapies that work with “Patient A” may not at all with “Patient B,” due at least in part in the natural genetic difference that exists among practically all living things. Zhang admits the field is still in its infancy, the promise it holds is vast: with the rise of genomics, scientists can untangle the genetic knot of cancer, tailoring customized treatment regimens unique to a person, start to finish.
Trailblazing cancer research for the last 20 years, Zhang has been witness to the evolution of cancer treatment, at one point co-directing a Genome Data Analysis Center under the National Cancer Institute-funded Cancer Genome Atlas program. He also served as Director of the Cancer Systems Biology Center funded by the National Foundation for Cancer Research for several years when at the MD Anderson Cancer Center. In 2016, he was recruited to the Wake Forest Comprehensive Cancer Center located in Winston Salem, North Carolina to lead the Center for Cancer Genomics and Precision Oncology and takes a direct role in the development of targeted therapies.
Moreover, Zhang, who is also an NFCR Fellow, instituted sorely-needed diversity in cancer research. While cancer is not particularly picky, some forms of it tend to show up more in specific ethnicities that, historically, were overlooked, often with great detriment: African-Americans have the highest death rate and shortest survival of any racial and ethnic group in the USA for most cancers.
“Our precision medicine/oncology considers health disparities a priority issue of our cancer center,” Zhang explains. “In our program, 14 percent of all cancer patients who are enrolled in our precision oncology trials are African-American patients, a percentage that is much higher than most cancer centers in the country. We have taken on a leading role in our effort in understanding the unique genomics features for cancer of African-American ancestry.”
For all its promise, Zhang stressed that precision medicine, and oncology, is still in its infancy. The single most rate-limiting challenge is the effective matching of genomic mutations with corresponding drugs. That being said, precision medicine/oncology is for everyone involved in cancer management. That includes patients and family members, doctors, researchers, pharmaceutical companies, funding agencies and insurance industries. Decisions have to be made through better research and better development of targeted therapeutics. Zhang is optimistic.
“The efficacy will continue to improve with the effort of national consortium such as Precision Medicine Exchange Consortium and Genomics Evidence Neoplasia Information Exchange,” he says. “There are ample proof-of-principle successes.”
American Cancer Society. (2019). Cancer Facts & Figures for African Americans. Retrieved from: https://www.cancer.org/research/cancer-facts-statistics/cancer-facts-figures-for-african-americans.html
Perry, David. (2019). E-mail interview with Dr. Wei Zhang.