Population Health Disparities In Cancer Care Promotes Precision Medicine

Mount Sinai researchers have found genetic differences between 14 tumor types in young adults compared to the same cancers in older adults. To address the population health disparities, researchers recommend a precision medicine approach for young adult patients.

The study was led by William Lee, PhD, Assistant Professor of Genetics and Genomic Sciences at the Icahn School of Medicine at Mount Sinai.

According to recent studies, cancer diagnosis rates among young adult populations are on the rise.  However, most current knowledge about treating various cancers is based on studies using older patients, creating population health disparities.

The research team analyzed the genomic data of 14 different types of tumors from 1,757 adult patients under the age of 50 and 3,608 patients over the age of 50. The data was provided by The Cancer Genome Atlas, a project funded by the National Cancer Institute.

“For each tumor, the researchers systematically compared genetic mutations, chromosomal alterations, tumor-immune system factors, and the potential to be treated with a known anti-cancer therapy. They then validated the results using additional samples from the International Cancer Genome Consortium,” the press release stated. 

The result indicated that each type of young adult tumor could be distinguished from the older version due to specific sets of hallmarks. For instance, the relative proportion of well-known mutations seen in low-grade gliomas changed significantly with the patient’s age. Comparatively, endometrial tumors in young adults tended to have more mutations than those in older patients.

However, there were some common trends across cancer types. Notably, the results suggested that the immune systems of young adults respond differently to tumors than those of an older age. According to researchers, this included responses by macrophage and dendritic cells.

“The researchers found several differences between how young and older adult tumors may respond to different treatment options, such as to drugs designed against cancer-causing mutations in the BRAF gene,” according to the press release.

“Here the results suggested that anti-BRAF drugs may provide effective treatment options for a higher fraction of young adult skin cancer patients than older ones who have the same tumors. In contrast, older colon cancer patients may benefit more from anti-BRAF treatment options than younger ones.”

The research authors made these results accessible to other cancer researchers. Moving forward, the team plans to work with other organizations to test out new precision medicine and treatment ideas to combat tumors in young adults.

This study was supported by the National Institutes of Health and the Icahn School of Medicine at Mount Sinai.