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Oh, New Mutation? Now, We'll Try This Treatment

At nearly every step of the way, genetic testing guided Evan Johnson's cancer treatment, the Wall Street Journal reports.

An initial test found that Johnson had a form of acute myeloid leukemia, driven by a mutation in called FLT3, that's linked with poor prognosis. His doctors at the Mayo Clinic attacked it with chemotherapy, number of different drug regimens — including a drug targeting the FLT3 mutation — and a stem cell transplant. In that time, Johnson endured life-threatening side effects to his treatment, the Journal writes. He then entered a clinical trial for an experimental AML drug. While he responded for a while, he relapsed.

While Johnson's leukemia was no longer responding to his current treatment, it had developed a new mutation, the Philadelphia chromosome that's associated with chronic myeloid leukemia and for which there are targeted therapies, his doctors found.

Based on that, they changed his treatment to chemotherapy and Sprycel, and then to Iclusig, a drug that targets both FLT3 and the Philadelphia chromosome. Now after a second stem cell transplant, Johnson has been in remission for a year, the Journal writes.

With regular genetic testing, "you could see the cancer evolution happen," Pashtoon Kasi, an oncology fellow at Mayo Clinic and one of Johnson's doctors, tells the Journal. This allowed Johnson's treatment to be "personalized in real time," he adds. "This is where oncology is headed down the line."