Advancing Cancer Care: NYU Langone’s Molecular Oncology Program

Alec Kimmelman, MD, PhD, chair of radiation oncology and director of the Laura and Isaac Perlmutter Cancer Center at NYU Langone Health, and Shridar Ganesan, MD, PhD, an expert in cancer biology and DNA repair and the inaugural director of the Center for Molecular Oncology, discuss the institution's new molecular oncology program.

At NYU Langone Health, this new program helps assess patients diagnosed with cancer using the most advanced molecular diagnostics available.

Read more about the evolution of molecular oncology in our latest special report.

Transcription:

0:10 | For many years, and we still do this, cancer was completely defined by what it looked like under the microscope. This is breast cancer, this is lung cancer, and like I said, we still do that, but we have additional information now that we can get by sequencing these tumors and learning what causes them to be the genetic drivers. It can tell us things about how they are going to respond to therapies. It can make them be able to use certain therapies that are targeted to these specific mutations. So, it is basically molecularly classifying tumors.

0:48 | What the Molecular Oncology Center at NYU Langone Health Perlmutter Cancer Center is doing is that it is offering this kind of molecular analysis to every one of our patients, wherever they come into our center. And it is doing both sequencing the tumor, which is what we were just talking about, but it is also relying heavily on a newer technology, which is circular sequencing a tube of blood that we take from patients very similar to the same tumor blood you would get when you go to your doctor and just get a simple blood test. We can actually sequence that and detect tumor DNA. And that tells us a number of things.

1:28 | It can actually tell us the presence of cancer or the absence of cancer. It can be quantitative in that it could say how much cancer is there. So, you can go where you have surgery and you think you cut out the entire tumor, and you are trying to make a decision whether or not the patient should get additional therapy, like radiation therapy or chemotherapy, and this could help guide that by saying, "Do we detect circulating tumor DNA?” It also allows us to look for, again, whether a patient would respond to a particular type of therapy. It allows us to match patients very rapidly with clinical trials that they may be eligible for.

2:07 | I think what makes this program, molecular oncology here special is that it is really to scale. [For a lot of places], you just go to the main campus in Manhattan or in the city, and you can get there. But here, you can go to any one of our 11 locations at the Perlmutter Cancer Center in Long Island, in Brooklyn, in Manhattan, and you still have that expertise in terms of molecular oncology. We have centralized molecular oncology tumor boards that allow us to discuss these patients and their molecular findings with the referring oncologists. So, it really is a comprehensive program throughout our entire network.

2:49 | The Center for Molecular Oncology is part of Alec Kimmelman’s vision for what the future of oncology would be like. The idea is that, you know, ultimately cancer is a kind of acquired changes to our genome, making us sick, is one way of thinking about that. And we think that now, with current technology, the molecular classification of cancer should be used, kind of in the upfront, both in the initial diagnosis and classification of cancer, as well as to to monitor disease and ultimately to help guide therapy and evaluate outcomes.

3:22 | One of the things we want to do is, right now, the use of genomic analysis of tumor tissue, as well as analysis of cell-free DNA, is kind of done mostly in the advanced setting and in the kind of haphazard way, and we would like to sit there and together with our clinicians across the NYU network to develop a system where this is being done routinely and regularly in a fashion with with patient consent, to get a better understanding of how regular monitoring will both help in the classification of cancer or options for treatment, both regular and clinical trials, and find new ways to manage patients during the course of their disease.