A major theme in the evolving understanding of cancer, including chordoma, is that patient outcomes are driven not only by how their disease presents and the treatment they receive, but also by the underlying biology of their tumors. For some types of cancer, this has enabled care to be personalized based on the underlying biology of each patient's tumor, increasing the odds of good outcomes while avoiding therapies that are unnecessary or unlikely to help. Yet chordoma patients and their doctors still face important treatment decisions largely blind to the implications of the biology of the patient's particular tumor.
To address this blind spot, multiple research groups are working to identify biological markers ("biomarkers") within tumors which could help determine patients’ prognosis and predict whether they’re likely to benefit from certain therapies. And with the help of a new $100,000 grant from the Chordoma Foundation, a new consortium has come together to begin to validate emerging biomarkers and help get them into clinical practice.
The consortium, which includes the University of Pittsburgh Medical Center (UMPC), Johns Hopkins University School of Medicine, MD Anderson Cancer Center, Mayo Clinic, Brigham and Women’s Hospital, and several other institutions around the world, has begun its first project: to validate findings from UPMC researchers, who found that patients whose skull base tumors have certain genetic markers might be able to refrain from radiation if surgery is successful in removing the entire tumor. That team, led by Georgios Zenonos, MD, used a test called FISH that examines tumor DNA for specific alterations, and linked the results to patient outcomes over time. For patients with skull base chordoma who are considering radiation therapy, this test may help inform their decision. Now, the new consortium is expanding UMPC’s study, increasing the sample size from 152 to over 1,000 tumors, including of the spine and sacrum.
The consortium's strength lies in its ability to validate biomarkers across a diverse patient population treated at multiple centers. They also have access to treatment and outcome data associated with each tumor, enabling correlations between biomarkers, treatments, and patient outcomes over time.
And this is just the beginning: While the consortium’s work is currently focused on decisions related to surgery and radiation, it complements efforts in Chordoma Foundation Labs and by our grantees to identify biomarkers that predict response to various drug therapies. The consortium is laying the groundwork to be able to rapidly validate new markers as they’re identified and speed up the benefits to patients.
The project is an important step forward in better understanding tumor differences in order to offer more personalized clinical care, and foreshadows a future in which patients experiencing a new diagnosis or recurrence will more confidently be able to choose a treatment path.