Can you imagine a simple test that will predict your chances of getting cancer? Can you further imagine a fast, painless treatment that will immunize you against a potential cancer? Or, if you were to have an active cancer, what if a simple, painless treatment or medication could shut down the disease for good. ..never to return. ..and with minimal or no side effects? And what if these things could be accomplished costing a small fraction of the cost of today’s treatments?

Questions like this are what led Bill Koman and his wife, Amy, to create and fund the Koman Center for Cancer Bioinformatics. “After spending two years going through various cancer treatments, anything that we could do to help make an outcome more successful for cancer patients and their families was our goal,” said Koman.

There is hope for improving survival of Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma and leukemia, and it lies within the human genome. Building on the discoveries of Washington University's renowned Genome Sequencing Center, oncologists and researchers at the Siteman Cancer Center and Washington University School of Medicine are at the forefront of using genetic markers and proteins to identify suitable cancer treatments, predict outcomes, reduce life-threatening complications such as infection, relapse and heart failure and increase the likelihood of cure. What they have lacked is the appropriate infrastructure for collecting, banking and recording information on the serum and blood samples that must be analyzed as part of the process.

“There has been an explosion of new therapies that have provided benefit to patients,” said John DiPersio, MD, PhD and Deputy Director of the Siteman Cancer Center. “Unfortunately, we have a rudimentary understanding of why, or how, they work.” DiPersio describes the long-term goal of the project as directly linking the human genome to both risks of developing diseases as well as to responses to therapy. Patients who are at risk can be monitored more closely and, where appropriate, interventions can be taken so that the disease does not spread or progress. DiPersio also points out the enormous potential of discovery, or understanding the biology of diseases and then developing a rational approach to targeted interventions.

The tools of this work are genomics and proteomics, two leading research technologies fueled with a torrent of scientific information via a third research technology, bioinformatics. Information is supplied in a constant stream from thousands of bio-medical research labs around the world via the Internet. Vast libraries of new knowledge are stored in data banks that are readily accessible to the world's bio-science community. Sophisticated computer applications allow data to be stored, searched, retrieved, analyzed, compared, illustrated and manipulated. The structure of genes, proteins, enzymes and other bio-molecules can be readily studied to determine their functions and relationships, with blazing speed.

Countless hypotheses that just a few years ago could be tested only by arduous, time-consuming trial and error by "in vitro" methods (in laboratory glassware) or "in vivo" methods (in living beings) are now being tested "in silico" (in the silicon of computers). Experiments and tests that once may have taken months, or even years, to complete are now being accomplished in hours, sometimes seconds. A researcher can access and use the work of colleagues worldwide and thus avoid going through many of the steps that might be required for a given project. By eliminating much of the duplication of effort, the scientific discovery process is leveraged from concept to results.

What enables these powerful capabilities is the science of bioinformatics, sometimes called computational biology. It is a branch of biologic science that deals with information, the digital bits and bytes that become an interactive picture of a gene or a protein, or a segment of DNA, or a report or publication about some biology-related research. Medical miracles that a short time ago could only be imagined are today becoming realities through the power of information as processed by the speed and problem-solving ability of computers.

We are in the age of information, and information is leading us to cures that were once thought to be beyond possibility. The Koman Center for Cancer Bioinformatics will be one of the first in the world linking genetics and proteomics of cancer patients with clinical outcomes. This source of pre- and post-treatment data will be particularly effective in cell transplant therapies by helping predict potentially deadly graft-versus-host disease. With Barnes-Jewish Hospital Foundation's funding, the center can maximize its potential by supporting a senior oncologist to lead all research initiatives and promote collaboration with other cancer centers.

“The final strength of this effort will be to enhance our ability to connect to genetics and genomics of cancer with other institutions around the world, so that the sum of our efforts will be far greater than each individual,” noted DiPersio. “We are racing to complete the sequence of the cancer genome, which will be the opening salvo for a new era of genomics and genetics for more effective cancer therapies.”

 From the Barnes-Jewish Hospital Foundation’s CORNERSTONES Magazine Summer 2007