Creighton doc offers cancer breakthrough

A Creighton University physician appears to be the first in the world to offer a way to guide the treatment of cancer patients by virtually re-creating chromosomes with computer technology.

Dr. Jill Hagenkord, who was recruited to Creighton from the University of Pittsburgh last year, has used the method to study cancer chromosomes for several years. Creighton Medical Laboratories launched the lab test this week.

The process in part provides a better image of damaged chromosomes in cancerous tissue. By understanding which chromosomes are affected, Hagenkord said, she and cancer specialists can better predict whether the tumor will be aggressive and what drugs will work against it.

"It's a completely new way of doing things," Hagenkord said.

Hagenkord said that, for now, the technology is appropriate only for certain kinds of brain, kidney, blood, breast and other cancers. In time, it may be applicable to many more kinds of cancer, she said.

The process, sometimes called "virtual karyotyping," has been used in cancer research for years. Hagenkord is the first, though, to apply the technique to lab work for actual cancer patients.

Dr. Jared Schwartz, the North Carolina-based president of the College of American Pathologists, called it a way to improve cancer diagnosis and determine what medicines will work best for a patient.

"I'm very familiar with Jill's work," Schwartz said. "This is the beginning of the end — the beginning of the end — of what's known as trial-and-error medicine."

Schwartz said: "Somebody's got to say 'It's ready for prime time, and we're going to start using it.' "

Hagenkord said her training has prepared her to be the one to unfurl it.

"You also have to have the courage to say 'OK, I'm the one willing to go,' " she said.

Hagenkord, a 40-year-old medical doctor who grew up in Altoona, Iowa, and graduated with honors from the University of Iowa, has an unusual background of molecular genetic pathology, or the study of disease at the DNA level, and pathology-cancer informatics, or the use of computers to analyze huge, complex sets of biological data.

Her process involves typical lab work, such as examining tumor samples under a microscope, placing them in a test tube and extracting their DNA. She then puts the DNA on a chip that is scanned into a computer, which rebuilds the patient's chromosomes virtually so they can be studied.

DNA is the blueprint of an organism's genetic makeup, and chromosomes are the package for DNA.

Dr. Warren Sanger, director of human genetic laboratories at the University of Nebraska Medical Center, said his institution has used similar technology clinically to discover birth defects. UNMC also has used it in cancer research, Sanger said, but isn't ready to roll it out for patient care.

While Hagenkord's technology does a good job of detecting some chromosome abnormalities, Sanger said, it still is unclear what some of those abnormalities mean for cancer diagnosis and treatment.

"This is a powerful potential tool down the line," he said.

Hagenkord agreed that her approach is not yet appropriate for some kinds of cancer, but she said research has shown it's effective for others.

Scientists for years have been able to examine chromosomes under powerful microscopes and determine whether they are damaged. They have diagnosed, for instance, Down syndrome before the birth of a baby. The technology has gradually improved and added computerization as a powerful ally.

Dr. Ralph Hruban, director of the Maryland-based pancreatic cancer research center at Johns Hopkins University, recently sent Hagenkord tissue from a cancer patient.

"It's a field that is moving forward in some very exciting ways," Hruban said of Hagenkord's area of expertise. "It helped guide the patient's therapy."

• Contact the writer: 444-1123, rick.ruggles@owh.com

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