by Oncology precision refers to a medical model that proposes the customization of cancer treatment according to a patient’s individual biology and expected response to a specific therapy. This model relies on molecular analysis of each patient’s cancer, enabling clinicians to pinpoint genetic mutations and other molecular characteristics that could determine the best treatment approach. By identifying specific molecular alterations in a patient’s tumor, precision oncology aims to match therapies that directly target these changes, while avoiding therapies unlikely to be effective.
Advantages Of A Precision Approach
There are several potential advantages to adopting its approach:
Increased Effectiveness
Focusing treatment based on a tumor’s molecular profile aims to select therapies that directly act on vulnerabilities in a patient’s cancer. This targeted approach may improve outcomes by choosing treatments most likely to be effective for an individual patient’s cancer genetics.
Reduced Side Effects
By avoiding treatments unlikely to benefit a patient, Oncology Precision Medicine seeks to reduce unnecessary toxicities from ineffective therapies. Limiting use of treatments that will not impact a patient’s specific tumor biology may help minimize harmful side effects.
Earlier Detection Of Resistance
Monitoring tumor DNA for changes during treatment helps identify new mutations leading to drug resistance earlier. Detecting resistance sooner provides opportunities to intervene with additional or altered therapies before cancer can progress significantly.
Personalized Monitoring
Analysis of circulating tumor DNA during and after treatment provides a noninvasive method to track a cancer’s response and resistance on an ongoing, personalized basis. This personalized monitoring approach guides precision therapies.
Emerging Testing Approaches
Continued advances in cancer genomic profiling technologies are making comprehensive molecular testing more accessible and affordable. Rapid sequencing panels can now evaluate hundreds of cancer genes simultaneously from tiny biopsy samples or blood draws.
Multi-omics Analysis
Moving beyond DNA alterations alone, multi-omics analysis of tumor RNA expression, epigenetics, proteomics and more provides a more in-depth understanding of cancer biology to better inform treatment selection.
Targeted Drug Development
Expanding precision oncology applications drives development of new drugs directly targeting specific cancer vulnerabilities revealed through comprehensive molecular analysis.
Areas Of Oncology Precision
Several distinct areas have emerged within the field of precision oncology utilizing molecular profiling to guide cancer treatment:
Biomarker-Driven Therapies
Certain FDA-approved cancer drugs target specific, well-defined molecular alterations known as biomarkers that are drivers of tumor growth. Examples include EGFR inhibitors for EGFR mutant lung cancers and HER2-targeted therapies for HER2+ breast cancers.
Genomically Matched Clinical Trials
Some phase I cancer drug trials only enroll patients with particular genomic alterations, mutations or fusions predicted to sensitize tumors to the investigational drug’s mechanism of action.
Tumor Mutational Burden
High mutation rate cancers, regardless of specific alterations, may respond best to immunotherapy due to increased expression of tumor antigens. Mutation quantification guides use of drugs like checkpoint inhibitors.
Pan-Cancer Biomarker Strategies
Some oncology precision approaches seek biomarkers common across multiple cancer types to identify patients most likely to benefit from targeted or immune-based therapies.
Foundation medicine and similar efforts provide comprehensive genomic profiling to match biomarker-identified patients to available clinical trials or off-label biomarker-matched treatments.
Liquid Biopsy Applications
Analysis of circulating tumor DNA from blood samples tracks changes in cancer genotypes over time and during therapies, aiding treatment decisions and early detection of emerging resistance.
Multi-Omic Analysis
Looking beyond just DNA alterations to evaluate additional molecular features like RNA expression, methylation and proteomics provides a more complete understanding of cancer biology.
Challenges Of Precision Oncology
While oncology precision holds promise, several challenges currently limit its widespread adoption in cancer treatment:
Tumor Heterogeneity
Cancer’s ability to evolve means multiple subclones with differing molecular profiles may exist within a single tumor and spread to other sites. Profiling a small biopsy may not detect full range of alterations.
Rapidly Changing Targets
As cancers evolve resistance to treatments, the molecular profiles guiding precision therapies must constantly be re-evaluated through repeat biopsies or liquid biopsies.
Rarity Of “Actionable” Alterations
Many tumors lack well-defined targetable genomic alterations. Greater biological understanding is needed to identify vulnerabilities in non-biomarker-driven cancers.
Cost And Accessibility
Comprehensive genomic testing remains costly, and results interpretation requires specialized expertise. Widespread adoption depends on lowered costs and broader provider experience with molecular data.
Clinical Validation Of New Targets
Expanding its applications requires further clinical trials validating newly discovered predictive biomarkers and their matched therapies.
High Failure Rate Of Targeted Drugs
While some biomarker-matched therapies show impressive responses, many clinical trials of promising targeted agents still fail due to acquired or intrinsic resistance.
Future Outlook For Oncology Precision Medicine
Despite numerous ongoing challenges, ongoing advances continue driving expansion of precision oncology applications, aided by regulatory approval of new targeted drugs and increasing clinical experience with molecular profiling. Multi-omics analyses may uncover new targets in currently non-actionable cancers. Liquid biopsies enhance dynamic treatment monitoring. Comprehensive genomic characterization of more tumor types will expand options for genomically-matched clinical trials. With further progress, precision medicine may eventually optimize treatment selection for most cancer patients based on deep molecular analysis of their individual disease.
*Note:
1. Source: Coherent Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
Money Singh is a seasoned content writer with over four years of experience in the market research sector. Her expertise spans various industries, including food and beverages, biotechnology, chemical and materials, defense and aerospace, consumer goods, etc.
