The Vanderbilt–Ingram Cancer Center Personalized Cancer Medicine Initiative (PCMI) team has established a database entitled DNA-mutation Inventory to Refine and Enhance Cancer Treatment (DIRECT) that contains information about the potential clinical significance of specific tumor mutations. DIRECT may enable a genetically-informed approach to cancer medicine—in other words, cancer therapy tailored according to the genetic makeup of individual tumors.
Currently, DIRECT catalogues drug response data from patients with non-small cell lung cancer (NSCLC) whose tumors harbor mutations in:
To compile the information in DIRECT, the PCMI team used a retrospective PubMed medical subject heading (MeSH) search to identify patient-level, mutation-specific, drug response data from different studies in NSCLC (Horn et al. 2011; Yeh et al. 2013). As of January 1, 2013, more than 1,800 individual patient entries including patient demographics, tumor mutations, and drug response data have been extracted from 165 papers and catalogued in the DIRECT database. DIRECT currently has information on 188 different primary EGFR mutations and 4 secondary EGFR mutations (Yeh et al. 2013).
The initial goal of the DIRECT database was to catalogue clinically relevant somatic mutations in lung cancer. The project began by cataloguing data from patients with EGFR mutations but will be expanding to incorporate data on all known mutations with potential clinical significance in various types of cancer.