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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Abstract	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.
AbstractList	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. 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. 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.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.
Audience	Academic
Author	Fisher, David E. Flaherty, Keith T. Friedman, Adam A. Letai, Anthony
Author_xml	– sequence: 1 givenname: Adam A. surname: Friedman fullname: Friedman, Adam A. email: aafriedman@partners.org organization: Massachusetts General Hospital Cancer Center, Harvard Medical School – sequence: 2 givenname: Anthony surname: Letai fullname: Letai, Anthony organization: Dana-Farber Cancer Institute, Harvard Medical School – sequence: 3 givenname: David E. surname: Fisher fullname: Fisher, David E. organization: Massachusetts General Hospital Cancer Center, Harvard Medical School, Dermatology and Cutaneous Biology Research Center, Massachusetts General Hospital – sequence: 4 givenname: Keith T. surname: Flaherty fullname: Flaherty, Keith T. organization: Massachusetts General Hospital Cancer Center, Harvard Medical School
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/26536825$$D View this record in MEDLINE/PubMed
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Snippet	Genome-based cancer therapeutic matching is limited by incomplete biological understanding of the relationship between phenotype and cancer genotype. This... 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...
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SubjectTerms	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
Title	Precision medicine for cancer with next-generation functional diagnostics
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