DNA mapping for cancer patients

DNA The human genome contains three billion pairs of code

Up to 100,000 patients with cancer and rare diseases in England are to have their entire genetic code sequenced.

The Prime Minister will announce £100m has been set aside for the project over the next three to five years.

The aim is to give doctors a better understanding of patients' genetic make-up, condition and treatment needs, and help develop new cancer treatments.

One human genome contains three billion base pairs - the building blocks of DNA.

Sequencing the code produces a huge amount of data. Although the price is falling fast, it currently costs £5,000 to £10,000 - which explains why no country in the world has embarked on mass DNA mapping on this scale.

When it will start - who will do the genome sequencing and analysis - has not been worked out - nor which patients will be eligible for the voluntary testing.

But the hope is by comparing genetic profiles of huge numbers of patients, it will allow scientists to understand why some do far better than others - and help in the quest for new treatments.

Privacy campaigners are concern such a move could allow personal data to be passed on to private companies, such as insurance companies.

Dr Kat Arney from Cancer Research UK: ''There could be very big benefits for cancer patients in the future''

But ministers insist the project is for medical research alone.

For existing patients, DNA mapping may lead to better targeting of medicines.

The power of this type of genetic analysis was demonstrated earlier this year when a study of 2,000 breast cancers showed the cancer should be thought of as 10 completely separate diseases.

Personalised therapies

There are already a handful of targeted treatments - for breast, lung, bowel and blood cancers - where tests for a single gene can reveal whether a patient is likely to respond.

For example, breast cancer patients are tested to see if their tumour is positive for 'Her2', a protein that can accelerate the growth of malignant cells. If so they can benefit from Herceptin, a drug which works on patients with high levels of the Her2 protein.

Whole genome mapping may yield more of these personalised therapies.

Speaking ahead of the announcement David Cameron said: "By unlocking the power of DNA data, the NHS will lead the global race for better tests, better drugs and above all better care."

The chief medical officer for England, Prof Dame Sally Davies, said: "Single gene testing is already available across the NHS ranging from diagnosing cancers to assessing patients' risk of suffering side effects from treatment.

"At the moment, these tests focus on diseases caused by changes in a single gene. This funding opens up the possibility of being able to look at the three billion DNA pieces in each of us so we can get a greater understanding of the complex relationship between our genes and lifestyle."

Stratified medicine

  • Cancer Research UK launched it 'stratified medicine' project last year. It aims to group, or 'stratify' patients into those who will respond best to particular treatments. DNA samples of 9,000 patients with breast, bowel, prostate, lung and ovarian cancer, and melanoma are being collected at seven centres across the UK. The genetic make-up of the cancer will be analysed and the key mutations noted. The information will be stored as a guide to help future research.

There are a number of existing projects seeking to improve understanding of the genetics of cancer, such as Cancer Research UK's 'stratified medicine' programme.

The UK is part of the International Cancer Genome Consortium which is planning to sequence 50 different cancers and catalogue their different mutations.

There are more than 200 types of cancer - it is a complex and highly resistant disease - the talk among specialists is less of cures and more of improved long-term outcomes.

So most of the benefits from these ambitious projects are likely to be among the next generation of cancer patients.

Fergus Walsh Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this

    Comment number 224.

    numbers should never be an issue when it comes to research, there is not that many surviving cancer patients, studies have included a lot more for the uptake.This is a well established subject, lets just let the experts get on with carrying it out.

  • rate this

    Comment number 223.

    @221: For many projects, the research team might be able to handle analysis (and we generally do). For a project of this magnitude, it would need dedicated bioinformaticians. With the technologies used for modern high-throughput sequencing, even a single genome generated by 454/Illumina is far more complex than those generated for the human genome project because of the depth of coverage.

  • rate this

    Comment number 222.

    we have to trust the expertise of the researchers, thats all you can ask as a cancer patient. I have seen some great research into all aspects of care, i have no reason to not be excited about this new research. If it saves my children, and their children from going through what i have it will certainly be money well spent. If it stops some nvasive treatment it will be even better.

  • rate this

    Comment number 221.

    At the end of the day, all i have is hope that one day their will be a cure, its quite often the research term that conduct their own evaluation, and that is the norm, they more often then not do their own analysis, i can make sense of this, but maybe that is because i come from a research background, this is not a very expensive piece of research, but it would have good outcomes for patients.

  • rate this

    Comment number 220.

    I'm more concerned about who is going to analyse all the sequencing data that comes from this project. There is currently a severe national deficit in experienced high-level bioinformaticians and computational biologists, with only limited funding going into training new ones. Just having the data (millions of bases per genome, thousands of genomes) is not enough - you need to make sense of it!

  • rate this

    Comment number 219.

    I don't think anything in the report suggested that the sequencing would be done by commercial companies... A vast amount of sequencing is generated through charity and government funded work at Sanger and in universities. This is where it would probably be done (and should be done). Of course, the reagents for 454/Illumina/SoLid are supplied by a commercial company, so they would profit...

  • rate this

    Comment number 218.

    I have had this idea in my mind for a while and even discussed this will a few of the professors in the bio-medical labs, having conducted some research into rare genetic diseases, I feel this project is extremely helpful and something I have already planned to do, not only will this help develop tests and diagnose certain diseases but also help people in the future.

  • rate this

    Comment number 217.

    This whole debate has been worthless, we have had people thinking more about tax's then the life of their children or themselves, i wouldn't want anyone to walk in my shoes, i live with the fact that this illness will one day kill me. Man up you lot, this is a terrible illness, you need to support any research that may lead to a cure. believe me, you wouldn't want to have cancer.

  • rate this

    Comment number 216.

    they do keep all biopsied samples from cancer, and of course we have the Cancer Registry. The majority of cancer patients will be glad of this, none of us want to see our children or their children having cancer, and to be honest, i think you have to be a cancer patient to really appreciate the impact it has on your life, especially when you are under 50 years of age.

  • rate this

    Comment number 215.

    this is the business ethics
    and this is for the NHS
    Its very hard to get the ethics and governance right on any research proposal, but get it right you must, confidentiality is so important and this country does recognise this issue.

  • rate this

    Comment number 214.

    As a research scientist specialising in sequencing I hope this is going to be done properly i.e. be of scientific/medical use.

    You need to sequence the tumour tissue *and* normal tissue for the results to be meaningful. Otherwise, it won't be meaningful.

  • rate this

    Comment number 213.

    if anyone wants my details they can have them, to carry out any research in this country they have to go through a very stringent Ethic's Committee, i know this as i do a lot in research, so i would have no worries whatsoever of giving my personal details, and both the NHS and Business departments are both governed by the goverment.

  • rate this

    Comment number 212.

    "You can get yourself sequenced for £600 now!

    Erm, no! Genotyping is not the same as sequencing.

    Genotyping only looks at about 0.5 million out of 3,200 million sites of the genome. Sequencing looks at almost all the 3,200 million sites.

    Genotyping ~ £300. Sequencing ~ £8,000

  • rate this

    Comment number 211.

    The fact that this was announced by the Department of Business and not by the Department of Health should send warning signs that our privacy will be under threat. The fact that your genome details could be sold on is very worrying.

  • rate this

    Comment number 210.

    Basitiats comments are no more extreme than several regular commentators . They are just from the opposite end of the spectrum."

    He inhabits a total dreamworld. His prescription for nirvana has never been tried anywhere let alone successfully. He appears to think any bad that happens is either insurable, dealt with by close family or the fault of the victim so no need for society.

  • rate this

    Comment number 209.

    208 justice

    Basitiats comments are no more extreme than several regular commentators . They are just from the opposite end of the spectrum.

  • rate this

    Comment number 208.

    Basitiat, i wonder what country you are from, you have been on here all day, so not sure that you work, i see so much money spent on illegal immigrants and terrorists that come to this country, then you go on about this being a bad idea, i am not a stranger in this country, i have paid taxes all my life, i have had cancer and i still work, get real!

  • rate this

    Comment number 207.

    Bastiat has been argumentative all day, he is not going to change now lol

  • rate this

    Comment number 206.

    How is it moral to force people to pay for a stranger's, albeit unfortunate, healthcare?"

    Because one day you may need to "force" them to pay for your healthcare. There are many conditions that any of us can contract at any time with no fault on us that are long term, costly and uninsurable. Indeed, it may be in your DNA. If you could not work due to such a condition what would YOU do?

  • rate this

    Comment number 205.

    for all you lot that are so against this, well, having cancer is truly awful, lets hope none of you ever get it, if you can't cope with this news, then you certainly will not cope with a diagnosis of cancer!


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