Cancer is the vanguard disease area for application of precision medicine. The intersection of genetics, immunology and stem cell biology has tremendous immediate and future applications to individualized, molecularly rationalized cancer treatments. At Columbia, a strong foundation has been established onto which strategic investments can be leveraged to propel us to a national leadership role in precision cancer care. In collaboration with the Department of Pathology, we have established NY State and CLIA-compliant clinical genomic sequencing capabilities including a 450-cancer gene panel, whole exome sequencing and RNA sequencing. In addition to identification of genetically-encoded therapeutic options, Dr. Andrea Califano is developing methods to identify non-genetically encoded vulnerabilities that broaden the therapeutic options available to patients. Columbia researchers have developed a sophisticated platform for developing patient-derived xenograft models, and are using these “patient avatars” to test therapeutic options for efficacy. Moreover, recent clinical recruitments have established robust Phase 1 (Richard Carvajal) and immuno-oncology (Naiyer Rizvi, Yvonne Saenger, Gary Schwartz) therapeutic options that leverage our genetic and systems biologic strengths to enable a broad armamentarium of therapeutics for patients. Finally, the application of patient-derived tissue stem cells for tissue regeneration (Siddhartha Mukherjee, Hans Snoeck, Stephen Emerson) is rapidly becoming a reality.
The vision for the future is to build an enterprise-wide precision cancer medicine program where all patients’ tumors will be fully characterized on a molecular level to facilitate enrollment onto precisely targeted clinical trials. Currently, this approach is already being pioneered to Pediatric Oncology patients through the Precision in Pediatric Sequencing (PIPseq) program. In this clinical program, genomic data has impacted clinic decision-making in 65% of all cases, including the identification of actionable alterations and avoidance of ineffective therapies.