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ST GEORGE — Intermountain Healthcare's Precision Genomics Center is diving into the past in hopes of changing the status-quo of treating cancer.
Hidden in a basement are almost 5 million blocks of tissue samples. Some date back 40 years. Intermountain doctors said it opens all kinds of possibilities of targeted treatments and genetic breakthroughs.
About 20 months ago, a doctor gave 71-year-old Kim Valdez a surprise cancer diagnosis.
"I went in to get my gallbladder out and the surgeon came and said the surgery went great, however, I found cancer," said Valdez. "He diagnosed me with stage IV ovarian, which was pretty scary because they said we can treat stage IV, but we can't cure it."
Valdez' oncologist, Intermountain Healthcare's Dr. Zachary Reese said, "Our first treatment was to give her chemotherapy — actually a combination of a couple of different drugs that are really considered standard treatment in the case."
Valdez' case turned out to be anything but standard. After a total of 18 rounds of chemo, doctor's turned to genetic testing.
"My mom had died of colon cancer two months before she turned 43. Pretty darn young," said Valdez. She had the same mutation in her DNA making her a candidate for immunotherapies.
"Patients with these mutations and a few others responded very well to immunotherapies, meaning treatments that are designed to help your own immune system recognize and kill the cancer cells," Reese said.
This is called targeted treatment, or precision genomics. "Precision genomics is a form of precision medicine for cancer patients that involves taking a small sample or biopsy of a patient's cancer and then looking at the DNA in that cancer to identify genes causing the cancer to grow," said Dr. Lincoln Nadauld, executive director of Intermountain Precision Genomics.
The Precision Genomics Laboratory aims to treat a patient based on genetic makeup rather than a type of cancer.
"We can offer patients new treatment options which in many cases means new hope and access to cutting-edge care." How cutting edge? "It's really new, it's very exciting. It's completely transforming medical oncology," said Nadauld.
It works like this: When the gene responsible for cell growth is altered, the cell will no longer grow in a structured manner, resulting in a massive tumor. Surgeons extract DNA from those cells and then map them using sequencing technologies. When a specific mutated gene is discovered, oncologists can use targeted drugs to deliver personalized treatment.
The doctors in Utah think the key to unlocking more cancer mysteries could lie behind a simple white garage door on the campus of LDS Hospital. It is there where Intermountain has stored almost 5 million tissue samples all encased in wax and frozen in time. Each sample is a small window into how that patient fought their disease.
"We believe that the answer to how we treat patients in the future are locked away in the samples from the past," Nadauld said.
Intermountain started collecting these samples in 1975 from all 22 of its hospitals. After 10 years, they are shipped to LDS hospital and stored in a temperature controlled but temperature-controlled basement. This treasure, or bio-repository as they call it, provides a map to make predictions about the future.
"We think the reason the asset is so viable because we can pull a sample out and now apply some of these new DNA sequencing technologies and do a whole genome analysis," Nadauld said.
The Precision Genomics Lab in St. George is relying on two brand new state-of-the-art million dollar machines to do all the heavy lifting or sequencing.
"What's unique about these machines they can sequence DNA faster and better than ever before," said Helaman Escobar, Precision Genomics director of translation science and research.
Just 10 years ago, sequencing one genome — which contains about 20-thousand genes — would take years.
"This machine then transfers the biological sample, which is the DNA, into a digital file," Escobar said.
Once the mutated gene is identified, doctors develop a treatment plan for the patient.
For Valdez, that was immunotherapy and a new drug.
"MY CA 125 — a test that measures the amount of the protein (cancer antigen 125) is in your blood — went from 674 down to 532 after one treatment. I was just like, 'Wow, this is wonderful targeted therapy.'"
And Valdez' numbers continue to drop, but unlike chemotherapy, she's kept her hair.
"Wow, this is magic, and I am really liking no side effects," she said. "I walk four to six miles a day, seven days a week. I go out hiking. Life is good."
Valdez's daughter is also a carrier of this mutated gene. So she will need testing every year. But the key to beating cancer is still early detection and getting your screenings.
Just this month, the Federal Drug Administration approved the drug Valdez is taking for a nontissue specific cancer. It's the first time the FDA has approved a drug for any cancer that has a mismatched protein.
