WSJournal #3. Matching A Tumor to a Drug. Our

WSJournal #3. Matching A Tumor to a Drug.

Our growing understanding of the workings of the human genome is posing a new challenge: How to use that data to change the course of disease. Consider cancer. As seen through a gene-sequencing machine, some cancers can appear as at least a dozen different genetic diseases, some of which have been shown to respond uniquely to a specific drug. But how do cancer doctors quickly match a patient's tumor with a drug that targets it?

One answer is a test developed by Foundation Medicine Inc., a Cambridge, Mass., startup whose scientific founders include one of the leaders of the Human Genome Project. The test, officially launched last June, enables doctors to test a tumor sample for 280 different genetic mutations suspected of driving tumor growth.

This changes "everything in terms of how we approach patients with cancer," says David Spigel, director of lung-cancer research at the Sarah Cannon Research Institute in Nashville, Tenn. He used the test in one patient with advanced disease and few apparent options. She turned out positive for an alteration in a gene targeted by several drugs currently in development. She was signed up for one of the studies. A short time later, "she's like a new person," he says. "She's off pain medicines. She gained her weight back."

Michael Pellini, Foundation's chief executive officer, says that more than 600 oncologists have requested the test, which lists for $5,800. So far, he says, about 70% of cases have turned up a mutation that is potentially targeted by a drug on the market or in a clinical trial.

In one recent case, Dr. Pellini says, a sample from a woman with advanced pancreatic cancer yielded a response for "her2," an alteration associated with a certain form of breast cancer. She was treated and her cancer responded to the breast-cancer drug Herceptin. Few oncologists would think to look for her2 in a patient with pancreatic cancer, he says.