MCW's Commitment to Advancing Precision Medicine 'Levels the Playing Field' for Patients with Cancer

Panelists speaking at conferenceThis fall, cancer advocates around the community gathered for the American Cancer Society Cancer Action Network (ACS CAN) Cancer Research & Innovation Forum to learn about important advancements in precision medicine—an innovative approach to cancer care that takes into account individual differences in a patient’s genes, environment, and lifestyle. The 11th annual event featured a presentation and panel discussion with MCW Cancer Center leaders; together, they shared how the institution is harnessing cutting-edge precision medicine techniques, investing in training and education programs, and building an inclusive workforce to bring the right treatments to the right patient at the right time.

Ensuring all people benefit from innovation

Cancer Center Director Gustavo Leone, PhD, kicked off the event with opening remarks on the revolutionary changes happening in cancer care and treatment right here in Milwaukee. He explained how new technologies are allowing MCW doctors to use “universal sequencing, the genome, epigenetics, proteins, everything,” to provide better, more personalized cancer care, and in a way that was unimaginable just 10 years ago.

Dr. Leone added that while these changes will have life-saving impacts across the community, science and innovation can also be a major cause of cancer disparities. He explained that sometimes the scientific community gets so excited about making progress that it leaves certain groups behind; he encouraged the audience to embrace innovations in precision medicine while also holding scientists accountable for making sure it’s accessible to all people.

“Progress only counts when everyone has the chance to benefit from it. I urge our community to hold our feet to the fire to ensure we’re being mindful of all populations as we move forward, especially during the beginning steps. I don’t know where I’ll be 20 years from now, but I do know I don’t want to be having conversations about cancer disparities,” he said.

Deciding the right cancer treatment is no longer a ‘guessing game’

In her presentation on precision medicine, Razelle Kurzrock, MD, FACP, Associate Director, Clinical Research, emphasized that “the future of cancer treatment is here,” and doctors now have the tools to identify exactly what is wrong with an individual patient’s cancer. Dr. Kurzrock used an analogy of a car to explain the progress being made in sequencing and molecular profiling—information that can be used to tailor cancer care to a person’s unique genetic makeup. She said, “The way we usually diagnose a cancer is by light microscope, which tells us where the cancer came from but doesn’t tell us anything about what is wrong with the cancer. That’s like taking your Toyota to a dealership and the mechanics know that Toyotas usually have problems with the spark plugs, but they can’t look under the hood to find out what is wrong with your particular car.”

“We’ve never had the tools to look under the hood before, and that means when we decide therapy, it’s kind of like a guessing game. We can now see the patient’s DNA, the code for life, which has errors in it, and we can know exactly what is wrong with that patient’s cancer. What’s been happening to sequencing is unbelievable; it’s breathtaking progress that is unparalleled in human history,” she said.

Dr. Kurzrock added that genomic sequencing is allowing scientists to reclassify cancers by their underlying molecular abnormality, leading to a paradigm shift where doctors, clinical research teams, and regulatory health agencies are now thinking about cancer at the DNA and gene levels. The novel MCW IPREDICT clinical trial, led by Dr. Kurzrock and Clinical Trials Office Medical Director Ben George, MD, is just one example of how the institution is driving these new personalized medicine strategies. The master protocol uses molecular profile-based evidence to determine individualized cancer therapy for patients with aggressive malignancies; it was made available to all in January.

“We’ve now entered a new stage of the revolution: N-of 1 clinical trial design, where we customize therapy for each patient. In classic clinical trials, the drugs are the center of the universe and we find patients to fit the drugs. Now, clinics are moving toward having the patient at the center of the universe. Instead of finding patients to fit the drugs, we find drugs to fit the patient,” said Dr. Kurzrock.

In closing, Dr. Kurzrock stressed that she hopes to sequence everyone that comes to the MCW Cancer Center because every patient deserves a diagnosis. She added that applying this strategy universally could eliminate disparities that persist in Wisconsin and throughout the United States. “We’re not picking and choosing which patients get the best technology or diagnostics. We’re doing it for everybody,” she said.

Supporting cancer researchers at all career levels

During the forum, moderator Debra Nevels, MSHCM, Program Manager, Community Outreach and Engagement, recognized that precision medicine holds great promise for patients everywhere, but especially for those in under-represented populations because it can help “level the playing field.” She asked panelist Kristina Kaljo, PhD, Assistant Director, Cancer Research Training and Education Coordination (CRTEC), how the center is preparing the next generation of cancer scientists to continue this important work and eliminate disparities. Dr. Kaljo said the team is in the community building relationships with scientists of all ages, even those in middle school. “Any time I have the opportunity to go into schools, classrooms, talk to students, or bring them to MCW, I’m doing it. That’s one of our biggest efforts,” she said.

“CRTEC supports the development and fosters inclusivity of cancer scientists at levels. We work to continuously sustain their enthusiasm and engagement, and make sure we’re diversifying the field along the way. That means bringing in each person’s perspective and lived experiences so we can ensure we’re tackling cancer from all angles,” said Dr. Kaljo.

In response to Dr. Kaljo, Nevels said that cancer researchers at all levels need support and to feel a sense of belonging; this is important for eliminating cancer disparities, driving impactful research, and improving patient outcomes. Turning to Lisa Sanchez-Johnsen, PhD, MS, Associate Director, Equity, Diversity, Inclusion and Belonging (EDIB), Nevels asked how EDIB—especially the piece about belonging—is translated into the center’s programs. Dr. Sanchez-Johnsen explained that she aims to create a space where all faculty and staff can share their voice and “embrace their true selves.”

“There are things we are doing from a cultural perspective so people know they don’t have to leave themselves behind. The idea of belongingness is integral in the Office of EDIB. We recently started Talk Story/Plática/Chat Sessions, where faculty and staff can share anything on their mind. These discussions help to open lines of communication and reassure the people who work at our Cancer Center that we value them for who they are,” said Dr. Sanchez-Johnsen.

Learn how we’re expanding access to precision medicine in MCW IPREDICT.