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 molecular profile of at least one sample of the individual's pancreatic cancer comprising at least one of nucleic acid and protein analysis for each of the members of the molecular profile, wherein the members of the molecular profile comprise ERBB2, ESR1, TOP1, KIT, and EGFR;
b. comparing the results of the at least one of nucleic acid and protein analysis in step a) to a reference to determine which members of the molecular profile exhibit a change as compared to the reference;
c. accessing a computer database to identify at least one drug therapy that interacts with each of the members of the molecular profile that exhibited a change as compared to the reference in step b); and
d. providing a computer generated report that indicates the at least one drug therapy identified in step c).
2. The method of claim 1 , wherein the identifying in step c comprises identifying a drug therapy from at least one of a review of an extensive literature database and data generated from clinical trials.
3. The method of claim 1 , wherein the measuring steps comprises performing an immunohistochemical (IHC) analysis of at least one protein.
4. The method of claim 1 , wherein the measuring step comprises performing gene expression analysis of at least one nucleic acid.
5. 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.
6. 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.
7. The method of claim 5 , wherein the expression micro array analysis comprises identifying which nucleic acids are up-regulated or down-regulated by determining whether the fold change in expression for a particular nucleic acid relative to the reference is significant at p<0.001.
8. The method of claim 1 , wherein the report includes the individual's test results of the at least one of nucleic acid and protein analysis in step a) and any proposed therapies based on those results.
9. The method of claim 1 , wherein the identifying in step c comprises identifying a plurality of agents that each interact with a different gene or protein from the members of the molecular profile wherein the specific agents have not previously been used for treating the individual's diagnosed pancreatic cancer.
10. The method of claim 1 , wherein the members of the molecular profile further comprise at least one additional protein selected from the group consisting of MLH1, MSH2, CD20, p53, Cyclin D1, BCL2, CD52, PDGFR, AR, CD25, and VEGF.
11. The method of claim 1 , wherein the members of the molecular profile further comprise at least one additional nucleic acid 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, ERBB2, 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, ADH 1 C, ADH4, AGT, AREG, CA2, CDK2, caveolin, and NFKB 1.
12. The method of claim 1 , wherein the biological sample comprises a blood sample.
13. The method of claim 1 , wherein the pancreatic cancer has progressed on standard front-line therapy.
14. The method of claim 1 , wherein the pancreatic cancer has progressed on at least two chemotherapeutic or hormonal regimens.
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 4 , wherein measuring the molecular profile for the at least one nucleic acid comprises contacting the at least one nucleic acid with primers configured to amplify at least one gene.
18. The method of claim 1 , wherein the measuring steps comprise performing genotype analysis of at least one nucleic acid.