Functional Precision Medicine Advances Brain Tumor Care

Functional precision medicine is helping personalize treatment for patients with brain tumors by testing drugs directly on a patient’s own tumor cells, according to Dr. John Crawford, medical director of neurology and co-medical director of the CHOC Neuroscience Institute.

In an interview with CURE, Crawford explained that neuro-oncology has evolved over the past 20 years from relying primarily on microscope-based diagnoses to incorporating genetic and molecular insights into how tumors grow and divide. Functional precision medicine builds on these advances by combining traditional pathology with molecular profiling and functional drug screening.

This screening process involves taking a patient’s tumor cells and exposing them to a range of drug compounds to evaluate which therapies are most effective at targeting the tumor. The goal is to use this information to guide treatment decisions tailored to the individual patient.

Crawford emphasized that no two tumors are exactly alike, even when they share the same molecular mutations. Differences in patient age, sex and other biological factors can influence how tumors behave. Functional precision medicine addresses this variability by focusing directly on how a patient’s tumor cells respond to treatment, rather than relying solely on broader tumor classifications.

By testing tumor cells, often collected during surgery, in a controlled setting, physicians can better identify which therapies may be most effective for that specific patient. Crawford noted that this approach is highly individualized and holds significant promise as an additional tool in treating brain tumors.

Transcript

What should they understand about functional precision medicine and how it differs from the traditional way doctors choose treatments?

It has been notable to watch neuro-oncology over the past 20 years, as the field has moved from largely microscope-based diagnoses to examining the genetics of cells of origin and what drives them to grow and divide. Now, functional precision medicine builds on those advances by incorporating findings under the microscope and the molecular characteristics of a tumor, along with what is known as functional drug screening. This approach uses a patient’s own tumor cells, exposing them to a variety of compounds to evaluate the effectiveness of different drugs, with the goal of applying those findings to that individual patient. It is another tool available to treat these tumors and is highly patient-specific.

There is essentially no such thing as two identical tumors. Even tumors that share the same molecular mutations can behave differently, which may be influenced by factors such as a patient’s age, sex or other biological characteristics. Functional precision medicine and drug screening are largely agnostic to these differences. Instead, they focus on testing the patient’s own tumor cells, often collected on the day of surgery, to determine which drugs are most effective at targeting that tumor in a controlled setting. This approach is more individualized and shows significant promise.

Transcript has been edited for clarity and conciseness.

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