System and method for determining individualized medical intervention for a disease state
A system and method for determining individualized medical intervention for a particular disease state, and especially for cancers, that includes the molecular profiling of a biological sample from the patient, determining whether any molecular findings including one or more genes, one or more gene expressed proteins, one or more molecular mechanisms, and/or combinations of such exhibit a change in expression compared to a reference, and identifying a non-specific disease therapy or agent capable of interacting with the genes, gene expressed proteins, molecular mechanisms, or combinations of such molecular findings that exhibited a change in expression.
1. A method for determining a personalized medical intervention for an individual having a diagnosed pancreatic cancer comprising the steps of:
a) measuring a gene and/or a protein expression level of each of ERBB2, ESR1, PGR, KIT, EGFR, PTGS2 and AR in one or more sample of the individual's pancreatic cancer;
b) comparing the expression levels of the genes and/or proteins measured in step a) to a reference;
c) accessing a computer database to identify at least one drug therapy that interacts with each of the genes and/or proteins that exhibited a change in expression as compared to the reference in step b); and
d) providing a computer generated report that identifies the at least one drug therapy identified in step c).
2. The method of claim 1 wherein the identifying step comprises identifying a drug therapy from at least one of an automated review of an extensive literature database and data generated from clinical trials.
3. The method of claim 1 wherein the measuring steps comprise performing at least one of an immunohistochemical (IHC) analysis and a micro array analysis.
4. The method of claim 1 wherein the measuring steps comprises performing an analysis using at least one of an expression micro array, a comparative genomic hybridization (CGH) micro array, a single nucleotide polymorphism (SNP) micro array, a fluorescent in-situ hybridization (FISH), and in-situ hybridization (ISH), and a proteomic array.
5. The method of claim 3 wherein the biological sample comprises a tumor and the immunohistochemical analysis comprises determining whether 30% or more of the tumor cells in the biological sample were +2 or greater staining the target.
6. The method of claim 3 wherein the micro array analysis comprises identifying which genes are up-regulated or down-regulated by determining whether the fold change in expression for a particular gene relative to the reference is significant at p<0.001.
7. The method of claim 1 wherein the report includes the individual's test results for the genes and the proteins whose expression was measured and any proposed therapies based on those results.
8. The method of claim 1 wherein the identifying step comprises identifying a plurality of agents that each interact with a different gene or protein wherein the specific agents have not previously been used for treating the individual's diagnosed pancreatic cancer.
9. The method of claim 1 further comprising determining the level of at least one additional protein selected from the group consisting of MLH1, MSH2, CD20, p53, Cyclin D1, bcl2, CD52, PDGFR, AR, CD25, and VEGF.
10. The method of claim 1 further comprising determining the level of at least one additional gene selected from the group consisting of BCL2, HIF1A, PDGFRA, PDGFRB, CDW52, ZAP70, SPARC, GART, GSTP1, NFKBIA, MSH2, TXNRD1, HDAC1, PDGFC, PTEN, CD33, TYMS, RXRB, ADA, TNF, ERCC3, RAF1, VEGF, TOP1, TOP2A, BRCA2, TK1, FOLR2, TOP2B, MLH1, IL2RA, DNMT1, HSPCA, ERBR2, SSTR1, VHL, VDR, POLA, CES2, OGFR, ASNS, NFKB2, RARA, MS4A1, DCK, DNMT3A, EREG, Epiregulin, FOLR1, GNRH1, GNRHR1, FSHB, FSHR, FSHPRH1, folate receptor, HGF, HIG1, IL13RA1, LTB, ODC1, PPARG, PPARGC1, VHL, Lymphotoxin Beta Receptor, Myc, TOP2B, Topoisomerase II, TOPO2B, TXN, VEGFC, ACE2, ADH1C, ADH4, AGT, AREG, CA2, CDK2, caveolin, and NFKB1.
11. The method of claim 1 , wherein the biological sample comprises a tumor sample.
12. The method of claim 1 , wherein the pancreatic cancer has progressed on standard front line therapy.
13. The method of claim 1 , wherein the pancreatic cancer has progressed on at least two chemotherapeutic or hormonal regimens.
14. The method of claim 1 , wherein the pancreatic cancer is a metastatic cancer.
15. The method of claim 1 , wherein the individual has undergone prior treatment for the diagnosed pancreatic cancer.
16. The method of claim 3 , wherein the immunohistochemical (IHC) analysis comprises contacting the biological sample with an antibody to each of the plurality of proteins.
17. The method of claim 3 , wherein the micro array analysis comprises contacting the biological sample with primers configured to amplify each of the plurality of genes.