Director's Corner

John L. Marshall, MD


Are we truly prepared for personalized cancer treatments?

A central theme of our work within the Ruesch Center is to "fight a smarter war" against cancer through the rapid incorporation of personalized molecular information into an individual's treatment plan. Our current one-size-fits-all approach to cancer care will simply not work in the world of GI cancers given that each cancer is molecularly unique (think: snowflakes) and, if that were not enough of a challenge, they change over time with new mutations occurring in real time.

To help in our fight, many groups have developed techniques that rapidly — and at an increasingly lower cost — determine great details about an individual cancer, sequencing the genes and measuring which proteins are "driving" the cancer's behavior. Increasingly, companies are selling these services to patients, and some insurance companies are covering the costs. But the reality is that those of us who make treatment recommendations and provide regulatory oversight are not yet sure how we will incorporate these highly complex data sets into our patients' care. It reminds me of the current issues with the National Security Agency and our cell phone records; they have all that information, but how are they going to use it to stop the bad guys without also invading the privacy of the good guys? While not a perfect analogy, that tension feels very similar to our daily struggle to treat our patients with cancer.

Each year, the Ruesch Center hosts a multidisciplinary symposium aimed at tackling fundamental but difficult barriers to our quest to cure GI cancers. This year, we are squarely focused on molecular profiling: Is it in the research stage or a new standard practice? We are pleased to have an incredible faculty representing key stakeholder segments of the cancer care industry, including the Food and Drug Administration, Centers for Medicare & Medicaid Services, private insurance companies, patient advocacy groups, renowned scientists, bioethicists, the pharmaceutical industry and the emerging industry of molecular diagnostics. If you are reading this, you are our target audience. We feel that everyone with an interest in learning more about our progress toward curing cancer will gain a great deal from the presentations and discussions in this year's symposium. It is only through a high-level interchange among ALL the key stakeholders that we will speed progress toward our collective goal to cure cancer.


Very best,

John L. Marshall, MD
Otto J. Ruesch Center for the Cure of Gastrointestinal Cancers
Georgetown Lombardi Comprehensive Cancer Center