Dr Michael D'Angelica: The Importance of Genomic Testing in Hepatobiliary Cancer

Michael I. D'Angelica, MD, FACS, of Memorial Sloan Kettering Cancer Center, gives insight on genomic testing and its growing role in cholangiocarcinoma.

Transcript

Can you discuss the importance of genomic testing as treatment options expand in diseases like bile duct cancer or other hepatobiliary cancers?

I think it's becoming more and more critical. Unfortunately, the truth is that currently, it's a relatively small percentage of the time that it's informative and can really change a treatment that someone is getting. But it's happens frequently enough that it's probably worth doing. And it varies by the type of cancer, and it's variable across the whole spectrum of oncology. But there's no question in my mind that these kinds of tests—whether it's testing the DNA for certain mutations, and then I think it'll expand to other types of genetic tests as well—this will become part of cancer. And again, it'll probably lead us to the idea that it's something else than the organ of origin that often will dictate the treatment. I hate to be a bit pessimistic, but at the current time, it's really a minority. But we're very hopeful that it's going to be a significant and growing percentage of patients that can get very targeted drugs specific to the tumor. We've always dreamed of personalized medicine—that we don't just treat cancer according to the the name it's been given, but rather to the cancer that a specific person has. Those of us who treat cancer patients realize this. We've known this forever, that every patient has their own version of cancer, and it's highly variable. It's just a matter of predicting the course and the response to drugs. This has been opened up by genetic testing of recent, and I would say that, in hepatobiliary cancers, it's definitely become more prominent and again, specifically in cholangiocarcinoma.