Precision medicine for cancer with next-generation functional diagnostics

Genome-based cancer therapeutic matching is limited by incomplete biological understanding of the relationship between phenotype and cancer genotype. This Opinion article proposes that this limitation can be addressed by functional testing of live patient tumour cells exposed to potential therapies....

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Bibliographic Details
Published in:Nature reviews. Cancer Vol. 15; no. 12; pp. 747 - 756
Main Authors: Friedman, Adam A., Letai, Anthony, Fisher, David E., Flaherty, Keith T.
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 01.12.2015
Nature Publishing Group
Subjects:
631/154/140
631/208/191
631/208/212/2166
631/67/1059
631/67/69
Biomedicine
Cancer
Cancer Research
Care and treatment
DNA sequencing
Genomics - methods
High-Throughput Nucleotide Sequencing - methods
Humans
Methods
Molecular Diagnostic Techniques - methods
Neoplasms - diagnosis
Neoplasms - genetics
Nucleotide sequencing
Oncology, Experimental
opinion-2
Precision Medicine
ISSN:1474-175X, 1474-1768, 1474-1768
Online Access:Get full text
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Summary:Genome-based cancer therapeutic matching is limited by incomplete biological understanding of the relationship between phenotype and cancer genotype. This Opinion article proposes that this limitation can be addressed by functional testing of live patient tumour cells exposed to potential therapies. Precision medicine is about matching the right drugs to the right patients. Although this approach is technology agnostic, in cancer there is a tendency to make precision medicine synonymous with genomics. However, genome-based cancer therapeutic matching is limited by incomplete biological understanding of the relationship between phenotype and cancer genotype. This limitation can be addressed by functional testing of live patient tumour cells exposed to potential therapies. Recently, several 'next-generation' functional diagnostic technologies have been reported, including novel methods for tumour manipulation, molecularly precise assays of tumour responses and device-based in situ approaches; these address the limitations of the older generation of chemosensitivity tests. The promise of these new technologies suggests a future diagnostic strategy that integrates functional testing with next-generation sequencing and immunoprofiling to precisely match combination therapies to individual cancer patients.
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ISSN:1474-175X
1474-1768
1474-1768
DOI:10.1038/nrc4015