Student genetic research projects at Concord High School suddenly meant more last week, when genetics researcher and guest speaker Michele Nikoloff explained how similar tests developed at Roche Molecular Diagnostics are used to improve cancer patient treatment.

CHS honors biology teacher Ellen Fasman said as a research leader, Nikoloff's cutting-edge work dovetails with her curriculum.

"We are studying the targeted therapy genetics approach for certain disease genetic disorders, pedigrees and mutations."

Fasman and Dr. Ernie Liu are among the highly credentialed CHS Science Department teachers who brought their classes to the scientist's PowerPoint presentation where the human stories and images seemed to intrigue students most.

Our students loved Dr. Nikoloff's lectures," Liu said. "The most important thing is that my students found out what they have learned in the classroom they can apply to the real world and make a difference for other people's lives."

Nikoloff said, "The field of genetics is rapidly evolving and it is important to prepare students for future developments. Genetics play a role in how drugs are metabolized and enzyme activity varies among different ethnic populations."

In the area of drug metabolism, she relayed to students the story of the unexpected death of a 13 day-old Canadian baby in 2006. The mother, who was subsequently found to be a genetically ultrarapid metabolizer of codeine, was taking

it for post-labor pain relief and breast-feeding the infant.

Metabolized codeine in the breast milk essentially gave the baby a lethal dose of morphine. Since then, measures have been put in place to prevent such incidents from occurring.

Now, physicians can order a genetic test which reveals how an individual patient metabolizes specific drugs.

Nikoloff said only 80 percent of patients respond to analgesic drugs, while less than 60 percent benefit from asthma medications and less than 15 percent of melanoma cancer patients improve with chemotherapy.

"There is a clear need to identify patients likely to respond to medication based on their genetic makeup," Nikoloff said.

Dylan Parisi, CHS honors biology student said, "I found it interesting how rarely treatments such as chemotherapy actually make a difference for patients."

Targeted therapy is based on testing for a patient's genetic markers to determine who is likely to respond to a particular medication. One benefit of these genetic tests is that physicians will not prescribe drugs that are genetically unsuitable. Nikoloff expects targeted therapy will be part of standard health care in the future.

Nikoloff said that treating melanoma patients with a drug targeted to work only in tumors with a specific mutation led to increased survival.

She showed striking images comparing the appearance of a patient with a deadly case of metastasized melanoma (skin cancer) before and after the targeted therapy treatment with the Zelboraf drug.

"Melanoma is the sixth most common cancer in the United States and amongst the most common fatal cancers in young adults, with 8,000 deaths per year," Nikoloff said.

One student lingered after the lecture with questions such as, "Why does genetically targeted drug therapy work better than chemotherapy?"

Nikoloff explained that targeted medication kills only cancer cells, whereas chemotherapy is designed to kill any dividing cells. The severe side-effects of chemotherapy are evidence of the destruction of the body's other rapidly dividing cells.

"Only 50 percent of patients respond to the average anti-depression drugs and sometimes these medications can be harmful," Nikoloff said. "Personalized health care aims to target the right medicine for the right patient at the right time."

That is just what students are doing, according to Fasman.

"Students are learning to research metabolic disorders and working on 80 to 90 genetic disorders. They look for biological markers which can predict a predisposition to illnesses such as cystic fibrosis, diabetes, asthma and other autoimmune diseases."

Fasman initiated the relationship with Roche in Pleasanton and said she appreciated the company allowing Nikoloff to spend the day addressing CHS biology and biotechnology classes.

Nikoloff is a biochemistry graduate from UC-Berkeley, has a doctoral degree from Carnegie Mellon University, and completed postdoctoral training in plant biology at the Carnegie Institution of Washington at Stanford University. She has developed tests for drug metabolism and cancer treatment.

"(Students) get excited about the possibility of experimenting and coming up with new solutions to diseases and global warming," Fasman said. "Students need to know the approaches being used in the manufacture of medicine."

Constantly on the lookout for experts and equipment to enrich her classes in the rapidly changing field of genetics, Fasman said it is challenging for teachers in the current budget-cutting climate.

"Thirty-two students have to take turns using a limited number of expensive pieces of biotechnology equipment. It can range from $100 for lab equipment, to $30,000 to $40,000 for a PCR (polymerase chain reaction "thermocycler")," Fasman said. "We buy the expensive equipment used when it becomes available through industry upgrades."

Contact Dana Guzzetti at dguzzetti10@gmail.com or call 925-202-9292.

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Concord High School students learn latest in genetics research

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