NAUTIL.US | TEXT SETS programs to study “exceptional responders”: thoserare of HIV in his body, and his case has inspired a study cancer patients who do well while nobody else does. to genetically engmeer HIV-positive patients’ cells to Cancer is a personal disease, Solit explains. Each resist the virus. tumor constitutes its own world of defective genes and In the past, cancer researchers weren’t able to proteins. By studying the genetic quirks of exception- capitalize on their unexpected outlier successes. Not al responders, physicians can systematically identify | enough was known about the biology of cancer, and weaknesses in cancer subtypes and blast them with the right tools hadn’t been invented. “Even if someone drugs that target their unique vulnerabilities. “It’s a had a complete remission, you had no way to figure out testament to how much has been learned about the — why,” says James Doroshow, director of the Division of genome in the past 30 years,” Solitsays.“We’vealways Cancer Treatment and Diagnosis of the National Can- wanted to find out why some individuals respond so __ cer Institute (NCI). That changed in the 2000s, when well. Now we have the capacity. It’s going to really _1t became possible to analyze the genetics of cancer change the way we treat patients.” tumors for clues. The first major success came with studies of the UNLIKELY CASES HAVE ANeminenthistoryinmedi- drug gefitinib in non-small-cell lung cancer (the most cine. The modern science of the mind owes a lot to common kind). Gefitinib helped less than 20 percent the freakish accident suffered by Phineas Gage, a of the people who took it, but a few outliers had dra- 19th century railroad construction foreman whose matic, rapid recoveries. In 2004, two Harvard groups job involved packing down explosive powder with a —_ found that the responders had mutations in the epi- three-and-a-half-foot-long iron tamping rod. On Sept. dermal growth factor receptor (EGFR) gene. EGFR is 13, 1848,