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THE CHAIM SHEBA MEDICAL CENTER AT TEL HASHOMER - ISRAEL

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ONE OF A KIND PERSONALIZED CANCER TREATMENT IN ISRAEL – HOPE FOR PATIENTS WITH SERIOUS ONCOLOGICAL ISSUES


A unique service, the only one in Israel, intended for patients with Oncological illnesses has been opened at the public Sheba Medical Center. The service’s mission is to customize a treatment program for each Oncology patient based on tailor-made and individually focused treatments and medicines.

As part of the service, doctors prescribe drugs to Oncological patients based on the genetic characteristics of the cancerous growths. For this purpose, every clinical case is carefully studied at Sheba’s Institute of Oncology, whose work led by Dr. Raanan Berger. In the near future, radically new individualized concepts for treating cancer are expected to dramatically change entire field of Oncology.

PERSONALIZED CANCER TREATMENT IN ISRAEL

Representatives of various fields of medicine are responsible for selecting individualized drugs for Oncological patients. At the preparatory stage, each patient undergoes rapid genetic analysis, during which the characteristics of the cancerous tumors are examined and its specific mutations are identified. The results are processed and scrutinized by a team of specialists. The analysis includes a comprehensive study of 409 cancer genes. To date, we have collected scientific evidence which shows that mutations in these genes make the tumor susceptible to drug therapy. Each patient’s healthy tissue also undergoes genetic research in order to obtain full information about each patient’s condition and prescribe appropriate treatment.

The project, in which Oncological patients receive treatment based on individual characteristics, is carried out with the participation of physicians, Oncologists led by Dr. Berger, as well as scientists from the Institute of Cancer Research at Sheba Medical Center (Head - Professor Gidi Rahab). Creating this service and its fruitful endeavors was made possible thanks to the close cooperation of various departments at Sheba, including: the Pathological Anatomy Department (Head - Professor Iris Barshak); the laboratory complex at the Institute of Cancer Research, where cancerous tumor tissues are analyzed (Head - Professor Nineth Amarillo); and the staff of the Bioinformatics Technologies Department, which analyzes the collected data. Surgeons and Radiologists play an active role in the service - they decide which sample of the tumor tissue will be selected for subsequent genotyping and mutation research. Important functions are also performed by Clinical Geneticists, who are consulted by physicians for the treatment of patients with mutations not detected in tumorous cells but in normal tissues. Program Coordinator - Dr. Judith Cohen, a leading researcher at the Institute of Oncology at Sheba Medical Center.

Individualized cancer treatments will radically change the entire sphere of Oncology

One of the most important stages of cancer diagnosis is the study of a sample of tumor tissue obtained through tumors biopsy. The obtained sample is additionally subjected to genetic analysis in order to formulate a personalized treatment plan for each patient. To date, the standard genetic analysis of tumors is based on two basic parameters. The first stage of this study is genotyping - sequencing all 24,000 genes that make up the human DNA, as well as the identification of specific mutations. The second step is to examine the genetic features found in a cancer patient. Genetic features that are examined include differences between cells due to the presence or absence of specific proteins that serve as building blocks of tissue. To create an accurate representation of tumor characteristics, the researchers analyze nearly twenty thousand proteins that are part of the cancer cell. "Following two phases of genetic analysis” - explains Dr. Berger –“we can judge how the malignant cell functions ad which mutations are present in it. Based on the available data and in accordance with the detected mutations, we can propose an individualized patient treatment. "

In recent years a number of authoritative scientific works have been published that convincingly prove the effectiveness of biologic therapy, which is also based on the knowledge and understanding of the genetic characteristics of each cancer. Even today, biological drugs are used extensively in modern Oncology: some of them are licensed for everyday clinical practice, and some still undergoing clinical trials. Examples include (Targeted) drugs used to treat breast cancer with a genotype of HER2 / neu positive. Specific mutations are present in breast tumors of this type that are targeted by the biological action of the drug. Also, biological therapy is practiced to treat lung cancer and patients with mutations in the EGFR gene, skin cancer and patients with mutations in the B-RAF gene, lymphoma with mutations in the CD-20 gene, and colon cancer with mutations in the K-RAS gene. Currently, approximately 60 new biological drugs that specifically act on various cancers containing certain proteins or characterized by specific mutations are undergoing clinical trials. According to preliminary data, the efficacy of these drugs is assessed to be very high.

Highly effective treatment at an affordable price

It must be emphasized that the cost of genetic testing for Oncological patients is significantly lower than the costs charged by private companies - both Israeli and foreign – that are involved in genetic research. The effectiveness of the treatment, chosen in accordance with the genetic characteristics of the tumor, is usually high and the side effects are less pronounced when compared with the conventional therapy. The treatment fee for biological therapy or immunotherapy in Israel is much lower than in the U.S.  
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