NAUTILUS EDUCATION | BETA PRODUCT patient (who doesn’t want her name made public) DOROSHOW OF THE National Cancer Institute says had such a wonderful response to everolimus, the tech- Solit’s work “turned on the lightbulb.” It showed how nology was ripe to analyze her entire tumor. the analysis of exceptional responders could be made The outlier patient had already gone through sev- systematic. Inspired by his example, the NCI is now eral rounds of treatment, including surgery at Memo- trawling through tts own archives, revisiting outlier nial Sloan-Kettering. That was another stroke of luck responses among the roughly 10,000 patients who because rt allowed Solit’s group to acquire samples of enrolled in NCI-sponsored clinical trials during the her tissue to be sequenced. Cancers typically start with last decade. Picture the long rows of crates in the gov- mutations that cause cells to divide too much, ignoring ernment warehouse atthe end of Raiders of the Lost Ark: normal stop signals and evading quality controls that There’s treasure in there somewhere, if only someone repair or prevent errors in DNA reproduction. “Cancer would look. “We ought to study these people more, is a disease of mutations,” says Solit. since we have the means now,” says Barbara Conley, The outlier patient’s cancer had accumulated 17,136 the associate director of the cancer diagnosis program mutations, of which 140 seemed most suspect, because at NCI, who leads the project. they appeared in “coding” regions of the genome, the In the few months since the project began, Con- segments that include instructions on how to build the ley’s team have already found about 100 exception- proteins that do the work in a cell. Out of those 140, al responders. The next steps are to find out if their two looked particularly menacing to Solit. In a gene tumors were biopsied, if that tissue sample is still sit- called TSC1, yust two of tts 8,600 DNA base-pairs were ting in a freezer somewhere, and whether