Rainier Nery Mozo, MD, Bs Biochem, FPCP

Redefining Precision Oncology with Genomics Medicine

After Human Genome Project was completed in 2001, a lot of studies were made in all fields of science as
well as medicine. In medicine, oncology is most influenced specialty by the advances in genomic
technology. Sequencing the cancer specimen, we have discovered that cancers from different organs and
cancers even in the same organs are “molecularly” different from each other. Meaning, there is a lot of
types of lung cancer, and cancer cells of lungs are different from those of the colon and other organs.
Furthermore, cancer management and treatment response depend also on the molecular type of the
cancer.

For Fluorescence in Situ Hybridization (FISH), we are routinely using this as standard of care for checking
Her 2-receptor status of patient with breast cancer. FFPE samples will be collected from biopsy of the
tumor or specimen excised from the operation. Patient noted with Her2 enriched or positive breast cancer
specimen will be managed with Trastuzumab. This is called targeted therapy.

For Comparative Genomic Hybridization (CGH) or Chromosomal microarray analysis (CMA), we are using
this as confirmatory test once we screened a sequence positive of large mutation using Next Generation
Sequencing (NGS). This is to ensure the presence of mutation before finally giving the results to patients.

If CGH is used as confirmatory for larger mutations, we are using Sanger sequencing as confirmatory
method for mutation involving single nucleotide.

Polymerase Chain Reaction (PCR) is the most commonly used in patient with lung cancer specifically
non-small cell of Adenocarcinoma type. Using PCR technique, mutation on EGFR gene is done. Patient
with noted mutation on exon 19,20, or 21 will be a good candidate for targeted therapy, specifically
tyrosine kinase inhibitor like gefitinib, erlotinib and afatinib. These drugs are currently the first line of
treatment of this type of cancer with EGFR mutation. Using any of these drugs, their cancer is expected
to be stable for 10 months to 1 year.

As per screening and molecular profiling Next Generation Sequencing (NGS) is most utilized technology.
Using NGS, DNA/RNA extracted from tissue blood or saliva can be processed and sequenced. In cancer
screening, we used NGS platform in checking for mutation related to hereditary cancers.
BIOGRAPHY
Currently, Dr. Rainier is pursuing a Postgraduate Diploma part-time course in Genomic Medicine and
Healthcare at University of South Wales-UK. He is about to graduate in his Masters Degree in Management
in Health Administration from Philippine Christian University.

He obtained his Bachelor of Science in Biochemistry in University of the Philippines Manila. He completed
his Doctor of Medicine degree in Pamantasan ng Lungsod ng Maynila-PLM (University of the City of
Manila).

He is a recipient of the Five Most Outstanding Campus Leaders (FOCAL) Award and Tanging Banggit Award
for his exemplary contribution to PLM in 2007 and 2008.

He is a certified internal medicine fellow of Philippine College of Physicians.

He has previously worked as resident physician in Johns Hopkins Singapore Medical Oncology Department
and Tan Tock Seng Hospital.

Dr Rainier has vast work experience in both the public and private hospitals as a specialist of Internal
Medicine managing acute and chronic diseases in both Singapore and Philippines.

Dr. Rainier is also a research grantee of the Philippine College of Physicians - Manila Chapter in 2014. One
of his research studies was on the effect of Moringa oleifera on HsCRP and Hemoglobin A1c levels of
diabetic patients. It was published and presented in different medical societies in the Philippines and was
also presented in British Medical Journal Forum in Quality and Safety in Healthcare 2015 in Hongkong.