Personalised Cancer Therapy

Question 1

What are the 4 Ps of Personalised Medicine?

Answer 1

Prediction, Prevention, Precision, Participation

Question 2

What can be used to predict Breast Cancer?

Answer 2

Diagnostic testing to locate mutations to BRCA1/2 gene

Question 3

How can Breast Cancer be prevented?

Answer 3

Weight management, avoid high alcohol consumption, careful contraceptive choice, doing physical activity, avoiding HRT if BRCA gene mutation is present, cessation/avoidance of tobacco

Question 4

How can Breast Cancer medicine be precise?

Answer 4

• CYP2D6 genotyping for Tamoxifen therapy - impaired CYP2D6 enzyme can lead to recurrence of Breast Cancer.
• Using PARP inhibitors - stops base excision repair leading to cell death in BRCA 1/2 mutated cancer
• Oncotype DX tests

Question 5

How can patients participate in Breast Cancer prevention/treatment?

Answer 5

Attending mammogram screening, choosing to have a mastectomy, doing regular exercise, quitting smoking

Question 6

What is DYPD genetic screening?

Answer 6

This is screening for a dysfunction in the enzyme dihydropyrimidine dehydrogenase. This enzyme helps in the metabolism of 5-FU and Capecitabine. A dysfunction in this enzyme can lead to a toxic build up of these chemotherapy agents and can cause death. All patients beginning 5-FU or Capecitabine treatment should be screened.

Question 7

What are the different biomarkers for Breast Cancer?

Answer 7

HER2+, Oestrogen receptor+