Dr. Anna Barker is Deputy Director of NCI and Deputy Director for Advanced Technologies and Strategic Partnerships. Doug Ulman is Chair of the NCI Director's Consumer Liaison Group, Chief Mission Officer of the Lance Armstrong Foundation, and a three-time cancer survivor. They spoke with the NCI Cancer Bulletin about The Cancer Genome Atlas Pilot Project.

Why were these three tumor types chosen?

Dr. Barker: We selected cancer types that were scientifically and technically appropriate to build TCGA and prepare the teams to analyze other tumors in the future. We also needed to locate and qualify existing biospecimen collections that were of high quality and sufficient quantity to meet the needs of the project. To accomplish these complex goals, we developed a rigorous, three-part selection process that allowed us to make the final selections.

Mr. Ulman: I think it's important for cancer patients to know that, while the cancers to be studied by this project come from existing biorepositories, samples to be studied will eventually be prospectively collected in clinical trials. Participating in clinical trials that meet TCGA criteria will be an excellent way to support the expansion of TCGA.

How will studying these cancers help patients with other cancers?

Dr. Barker: This pilot phase has been designed to study a few cancer types that hold the most promise for helping researchers understand how to design and conduct future studies on a wide range of tumors. TCGA will support the development of new technologies aimed at overcoming the current limitations in genomic analysis and bioinformatics technologies. Another goal is to develop data analysis tools that will allow clinicians to use this new molecular information to better understand subtle differences between subtypes of certain cancer, how tumors develop and progress, and why some cancers respond to certain treatments and not others.

Mr. Ulman: By focusing first on the cancers that will be studied in the pilot phase of TCGA, we expect that researchers will begin to understand how genomic changes at the molecular level may impact all types of cancer. These findings will eventually help to find new ways to target therapies and improve outcomes for all cancer patients.

How will TCGA affect diagnosis and treatment of cancer patients?

Dr. Barker: Achieving the long-term goal of TCGA will benefit patients by enabling the discovery and development of the molecular biomarkers needed to develop targeted interventions to stratify patients for clinical trials, monitor patients on therapy, and define and develop new molecular targets. Discoveries in cancer genomics already have helped identify several new treatments that target cancer-related molecules. For example, Gleevec effectively treats chronic myelogenous leukemia, gastrointestinal stromal tumors, and several other cancers. Another product of cancer genomics research, Herceptin, effectively treats about 20 percent of breast cancers that capitalize on a specific genetic anomaly.

Mr. Ulman: Understanding the genetic changes that cause the uncontrolled cell growth that characterizes cancer will enable researchers and clinicians to develop new diagnostic techniques and targeted therapies, leading to improved outcomes for all cancer patients and, eventually, cancer prevention.