HOUSTON, TX – Dr. Apostolia M. Tsimberidou, MD, PhD, Department of Investigational Cancer Therapeutics, Division of Cancer Medicine at the University of Texas MD Anderson Cancer Center in Houston recently spoke with The National Herald about her research and findings which were reported in the media in June. Dr. Tsimberidou, originally from Volos, told TNH that she always wanted to go into science from a very young age. Her mother’s diagnosis with cancer contributed to her determination to follow a career path in science and find a cure for the terrible disease.

Dr. Tsimberidou studied Medicine at the Aristotelian University of Thessaloniki, and then earned her doctorate at the Kapodistrian University of Athens. Her training also included an Internship/Residency in Internal Medicine at the G. Papanicolaou Hospital in Thessaloniki; and a Residency in Internal Medicine at the Theagenion Cancer Hospital in Thessaloniki. She was also a Fellow in Hematology at the The University of Athens, First Department of Internal Medicine, Athens, a Postdoctoral Research Fellow, Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, and Postdoctoral Research Fellow, Leukemia, also at The University of Texas MD Anderson Cancer Center, in Houston.

The researchers led by Dr. Tsimberidou presented their findings at the annual conference of the American Society of Clinical Oncology in Chicago. Tsimberidou is one of the pioneers in promoting cancer prevention in the United States. She noted that the presentation, focused “on Precision Medicine: Clinical outcomes including long-term survival of patients according to the pathway targeted and includes the results of the IMPACT study.”

She told TNH that the research began in 2007, “we started the first Precision Medicine study across tumor types, ‘Initiative for Molecular Profiling in Advanced Cancer

Therapy’ or IMPACT.”

“We hypothesized,” she said, “that tumor molecular profiling will optimize selection of anticancer therapy, leading to improved outcomes compared to the standard approach. “Patients with various tumor types, who exhausted standard treatment options or with rare cancers are referred to our Phase I program for investigational therapy. CLIA-certified, tissue molecular testing was ordered. The number of genes analyzed ranged from 1 to 50, depending on the time of testing and included genes in the PI3K/Akt/mTOR pathway, MAP kinase, receptor tyrosine kinase, and other pathways.

“Patients with tumor alterations were treated with matched therapy when possible. If matched therapy was unavailable, they received non-matched therapy. Patients were treated on clinical trials with investigational agents against various targets or on trials with FDA-approved drugs for other indications as single agents, or in combinations.

Consecutive patients who had tumor molecular profiling were included in the analysis, which was retrospective and exploratory.

“From 2007 to 2013, tumor molecular testing was ordered in 3,743 patients. 1,307 (35%) patients had at least 1 molecular alteration.

Of these patients, 711 received matched targeted therapy and 596 non-matched therapy. The median age was 57 years. 39% were men.

Patients were heavily pretreated. The median number of prior therapies was 4, ranging from 0 to 16.

The most common cancers were gastrointestinal, gynecologic, breast, melanoma and lung cancer.

The overall objective response rate was 16.2% in the matched group vs. 5.4% in the non-matched group.

Additionally,18.7% of patients had disease stabilization for at least 6 months in the matched group compared to 14.7% in the non-matched group.

“The 3-yr overall survival rate was 15% in the matched targeted group compared to 7% in the non-matched group. The 10-yr overall survival rate was 6% vs. 1%, respectively.”

Dr. Tsimberidou noted that, “When we added the type of therapy in the multivariate analysis, non-matched targeted therapy was associated with shorter overall survival, in addition to the previously described baseline characteristics. Therefore, matched targeted therapy was an independent factor associated with longer overall survival. In conclusion, our data demonstrate that matched targeted therapy was associated with long-term survival.”

About precision medicine, Dr. Tsimberidou pointed out that “results of ongoing clinical trials, including our randomized IMPACT2 trial and ASCO’s TAPUR, will help implement Precision Medicine in Oncology.

“Since we started the IMPACT study in 2007, the term ‘precision’ or ‘personalized’ medicine has evolved. Precision medicine currently refers to the use of targeted therapy that inhibits specific biologic abnormalities that are thought to cause carcinogenesis or to the use of cancer immunotherapies to generate an immune response against cancer.

Implementation of Precision Medicine requires:

Complete understanding of tumor biology, including a patient’s immune characteristics that drive carcinogenesis.

Discovery of effective drugs and development of therapeutic strategies that inhibit carcinogenesis. The definition of precision medicine should be rigorous.

“Finally, patients with cancer should have access to next generation sequencing and immune marker testing as well as to new drugs at the time of diagnosis and during the course of their disease to optimize treatment selection.

In closing, I am optimistic that in the next few years, we will dramatically improve the outcomes of patients with cancer with increasing implementation of precision medicine.”