Navigating the Genomic Landscape of Cancer in Asians

Precision medicine — a clinical paradigm that tailors treatments specifically to patients based on their genetic and lifestyle characteristics — may have only recently become a buzzword. Still, aspects of it are already being practiced clinically, albeit to a limited degree. Before receiving a blood transfusion, for instance, doctors need to match donor and recipient blood types to avoid dangerous complications. 

However, for most conditions, doctors fall back on more of a one-size-fits-all strategy to fill prescriptions, which isn’t always effective for all patients. Cues from genetics can streamline this therapeutic decision-making process, informing better, safer, and more efficient health management.

The future of cancer treatment stands to benefit greatly from a deeper understanding of the genetic interplay involved in disease development. A recent study, for example, has identified that an individual’s ancestry is linked to their risk of lung adenocarcinoma. The majority of Caucasian patients tend to be male smokers. However, in Asian patients, non-smokers with a mutation in epidermal growth factor receptor, or EGFR (a cell-surface protein involved in cell growth) tends to be common.

A study published in the journal Nature Genetics details researchers’ efforts into uncovering other genetic elements involved in lung adenocarcinoma development among East Asian populations.

The team first obtained biological samples from a large cohort of lung adenocarcinoma patients from China and Singapore.They then used whole-exome and transcriptome sequencing to take a deep dive into the genetic intricacies of these patients’ genomes, comparing to available reference data from patients with European ancestries.

Interestingly, the team identified stability differences in the genomes of East Asian patients, which influence cancer progression and survival rates. Data analysis also highlighted the presence of a rare tumor type within East Asian populations, characterized by elevated inflammation and high immune cell activity.

“This may represent a unique feature of the tumor microenvironment in lung cancer in Asians,” said Daniel Tan, a Senior Clinician Scientist at the Genome Institute of Singapore (GIS). “With the burgeoning pipeline of new immune targets, our analysis could shed light on novel immunotherapy strategies.”

The outcome of these studies shed light on how much value genetic data has for mapping therapeutic strategies and predicting patient outcomes. Collecting more data from Asian populations is critical for closing the massive diversity gap present in our current genomic databases. Indeed, genomes from the Asians account for only six percent of all recorded sequences. 

As the next steps, the team plans to link more clinical features to signature genetic patterns to empower healthcare teams to make more data-driven decisions for their patients. “In the near future we hope to deploy these selection features in the clinic prospectively,” Tan said.

Sources: Nature Genetics, A*STAR Research.