When a cancer drug fails, oncologists often fly blind. A precision technique might light the way

It seemed as if Logan Jenner had the best possible chance for a cure. Diagnosed at age 3 with acute myeloid leukemia, an aggressive blood cancer, Logan happened to have a targetable mutation that occurs in a small minority of childhood AML cases, making it possible for him to receive a precision therapy drug that — with chemotherapy — got him to a point where he could receive a bone marrow transplant.

But the transplant wasn’t enough. A year and a half later, the cancer showed back up on routine blood work. For patients who relapse or don’t respond to therapy in the first place, the odds of a cure plummet rapidly. In Logan’s case, with relapsed AML, the three year survival rate “after transplantation is not more than 30%,” said Maggie Fader, the Jenners’ pediatric oncologist at Nicklaus Children’s Hospital in Miami.

Part of the problem is that it’s not clear exactly which of hundreds of cancer treatments should be tried next. So in many cases, doctors simply make their best guess for a regimen.

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