Precision oncology for patients with advanced cancer: the challenges of malignant snowflakes
Precision oncology for patients with advanced cancer: the challenges of malignant snowflakes
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DOI：
10.1080/15384101.2015.1041695
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发表时间：
2015-07-18
期刊：
影响因子：
4.3
通讯作者：
Giles, Francis J.
中科院分区：
文献类型：
--
作者：
Kurzrock, Razelle;Giles, Francis J.
精准肿瘤学意味着根据每个个体及其癌症的独特分子和生物学特征进行定制治疗。基因组测序领域的显着技术进步以及靶向药物和免疫治疗药物的日益普及促进了其实施。然而，下一代测序可能是一项颠覆性技术，因为其结果表明临床研究和实践的经典范例与转移性恶性肿瘤中遇到的复杂现实不太相符。事实上，很明显，晚期肿瘤具有异质的分子景观，并且患者之间的分子景观大多不同。传统的临床研究/实践模式以药物为中心，其策略是寻找患者之间的共性，以便将他们分组并进行类似的治疗。然而，如果每位患有转移性癌症的患者都有独特的分子组合，则需要一种新的以患者为中心的多合一方法，利用个性化定制的治疗方法。
Precision oncology implies customizing treatment to the unique molecular and biologic characteristics of each individual and their cancer. Its implementation is being facilitated by remarkable technological advances in genomic sequencing, as well as the increasing availability of targeted and immunotherapeutic drugs. Yet, next generation sequencing may be a disruptive technology in that its results suggest that classic paradigms for clinical research and practice are a poor fit with the complex reality encountered in metastatic malignancies. Indeed, it is evident that advanced tumors have heterogeneous molecular landscapes that mostly differ between patients. Traditional modes of clinical research/practice are drug centered, with a strategy of finding commonalities between patients so that they can be grouped together and treated similarly. However, if each patient with metastatic cancer has a unique molecular portfolio, a new patient-centered, N-of-one approach that utilizes individually tailored treatment is needed.