Personalised Cancer Medicine: Fulfilling the Promise

Abstract

The continual increase in global cancer incidence has created a huge need for new and more effective cancer drugs. However, success is often limited by the heterogeneity among patients, which frequently leads to the failure of patients to respond to a drug together with toxic side effects. Personalised medicine uses our advancing molecular understanding of disease to provide the most efficient medical care for individual patients, depending on their unique clinical, genetic and environmental state. Various types of biomarkers assist this process by enabling prediction of clinical outcome on treatment, or measuring effect of treatment which is then correlated with a clinical endpoint. Omics technologies such as genomics, transcriptomics and proteomics are crucially important in the personalised medicine approach as they enable the analysis of multiple and large datasets to stratify patients into responder subgroups.

Key Concepts:

  • The increase in global cancer incidence calls for more effective therapies.

  • Personalised medicine identifies patients who respond differently to treatment.

  • Genetic and molecular heterogeneity in tumours contributes to variable treatment response.

  • Biomarker development is crucial for personalised cancer medicine.

  • Biomarkers can be prognostic, predictive and pharmacodynamic.

  • Molecular imaging enables the response to treatment to be visualised.

  • High‐throughput omics technologies allow analysis of large amounts of information on the healthy and diseased states.

Keywords: personalised medicine; cancer biomarkers; cancer genomics; omics technologies; targeted therapy; molecular imaging

Figure 1.

Schematic representation of the need for patient stratification from a diverse group with the same disease into those which are likely to respond to treatment and those who are not.

Figure 2.

Schematic workflow for personalised medicine in cancer care. To predict the individual risk score for each patient, the genetic heritage and environmental influences have to be taken into account. Although the conventional pathological analysis of cancer continues to be an essential analytic tool, newer omics technologies will enhance the diagnostic possibilities. An iPOP can be obtained by the combination of several omics technologies. These data have to be collected, integrated and analysed, so that an individual risk score can be assigned. Finally, an optimal treatment will be given to each individual, minimising side‐effects and effort for the patient to increase quality of life.

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Olzscha, Heidi, New, Maria, and La Thangue, Nicholas B(Nov 2013) Personalised Cancer Medicine: Fulfilling the Promise. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0025180]