Diagnostic and Theranostic Medicine division
The division’s main missions are:
- Offering analysis of samples (biopsies, excised tissues, cytological punctures, blood exams, etc.) for patients to establish diagnosis, identify the prognosis for cancers, identify possible treatment targets, particularly within clinical trials,
- and identify cancer predisposition syndromes to ensure that each patient receives optimal treatment.
These morphological and molecular analyses are performed for patients at Institut Curie and from other centers, in particular for molecular and pathology analyses as part of a second-opinion process.
- Research: physicians and biologists from the division are taking part in or leading a number of clinical and translational research projects. The Biological Resource Center and the Experimental Pathology Laboratory, located in the Pathology department in Paris, are two essential platforms for institutional research projects and projects in partnership with other institutions or industrial players.
- Teaching: a number of physicians and geneticists are involved in various university and post-university teaching programs in anatomy, pathological cytology, genetics and immunology. The division also has several medical residents, medical students and masters and scientific postdoctoral students.
Conducting the analyses
The cancer diagnosis is based, first of all, on the analysis of the tumor tissue taken by biopsy or from excised tissue. This analysis considers the patient’s clinical history, the treatments received, the risk factors and the anatomical context of the disease. The diagnosis is essential before any decision regarding treatment. At the crossroads between clinical, biological and imaging functions, the pathological anatomy and cytology procedure is a diagnostic test based, among other things, on morphological, macroscopic and microscopic observation, complemented by additional analyses, including immunohistochemical analysis, in-situ and molecular hybridization on the tumor tissue, and on the circulating tumoral DNA, to establish the prognosis and identify treatment targets.
The diagnosis of predisposition to cancer is based on both the consultation of patients, during which the geneticist establishes their personal and family history, and the analysis of the sequence of genes predisposing to cancer, through massive parallel sequencing approaches.
Precision medicine is here to stay
The therapeutic decisions in oncology today are based on cancer diagnosis, clinical context, prognostic factors and, increasingly, identification of theranostic markers, which predict the response or resistance to targeted therapies. This activity involves concerted efforts between geneticists and pathologists. Clinical pathologists and geneticists play an active part in the multidisciplinary consultation meetings (RCPs) and, in particular, molecular RCPs in-house or with other centers for clinical trials.
Innovation is a driving force in this division in order to provide patients with the latest technologies in analyzing genome anomalies present in the tumors, and identifying predictive markers of the effectiveness of therapies and in the patient’s constitutional or circulating DNA.
The strength of the Diagnostic and Theranostic Medicine division at Institut Curie is the synergy of expertise in pathology, genomics, immunology and clinical bioinformatics, and its close links with research in each of the hospital’s leading specialties (senology, ophthalmology, pediatrics, gynecology, soft tissue sarcomas and so on). This link with research is what makes us unique and provides access to efficient technological monitoring and numerous research projects.