Published online 26 August 2011 | Nature | doi:10.1038/news.2011.508

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Britain to launch personalized medicine project

Pilot programme will combine genetic tests with centralized data.

cancer patientA new programme aims to help cancer patients to receive better treatment, and researchers to develop new ones.SAM OGDEN/SCIENCE PHOTO LIBRARY

A UK pilot project for mass genetic screening of cancers will begin next month. The project will combine personalized medicine and centralized research, with the aim of benefiting patients and scientists.

Led by the charity Cancer Research UK, the Stratified Medicine Programme will enrol 9,000 people with breast, colorectal, lung, prostate, ovarian and skin cancer in the first, two-year phase of the project.

Surplus material from biopsies on the tumours will be sent to three centralized laboratories and tested for specific genes and mutations. Eventually it is hoped that this information can be used to tailor treatments to a patient's cancer. At the same time, the data will be held centrally and offer researchers a resource for improving medicine from the top down.

Many US medical centres have established their own, localized, personalized medicine programme and other countries are pursuing similar initiatives. France's national cancer institute INCA is leading a programme to detect biomarkers in lung and colorectal cancers and melanoma.

But most existing programmes are focused either on the patient care aspect or on the research side of things, says James Peach, director of the Stratified Medicine Programme.

"We felt we could try and do both," he says. "What we're doing over the next two years is a demonstration of how you could do individual genetic testing but also a research infrastructure project."

Huge benefits

Under the Stratified Medicine Programme, data on the tumour samples and the people from whom they came will be analysed in a national database. "We will make this information as open as possible while protecting the rights of the patients," says Peach.

Peach compares the planned collection to the existing General Practice Research Database, a huge set of anonymized primary-care records lauded by many British scientists.

Creating something similar with thousands of cancer samples and data could bring huge benefits to researchers.

"That's one of the big endpoints of this," says Gareth Morgan, a haematologist at the Institute of Cancer Research in London, which is one of the 'technology hubs' where samples collected under the new project will be analysed.

"If you have a sample set of 3,000 patients, say, where you have all of the DNA already extracted, you have some idea of what treatment they've gone for and their outcomes. To be able to use that study down the line is going to be invaluable."

Personal approach

The Stratified Medicine Programme is part of a wider thrust towards personalized medicine, which has seen some doctors moving beyond the gene-specific tests proposed under this initiative to whole genome sequencing for patients (see: US clinics quietly embrace whole-genome sequencing). However, for a nationalized health system such as that in the United Kingdom, a gene-specific approach is likely to be far more cost effective to apply widely.

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In 2010, a report from Britain's Royal College of Pathologists warned that molecular diagnostic tests were "provided patchily" in the United Kingdom. More recently, John Bell, chairman of the UK National Health Service (NHS) Human Genomics Strategy Group told The Times that the health service was "completely unprepared" for the advance of genomic medicine.

The new pilot programme will not actually influence treatment decisions, because it is a proof of concept. But if successful, it could provide a model for bringing personalized medicine to the United Kingdom. This is likely to be increasingly important as, for example, drug companies look to identify which patients will benefit from expensive targeted therapies before they are administered.

Timothy Aitman, a physician and genetics researcher at Imperial College London, says the new initiative is a clear acknowledgement of "the increasing importance of genomic investigation in cancer".

"It stands to advance the field of personalized cancer management and to increase awareness of the benefits of genetic investigation for cancer patients," he adds. 

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