Impact of the Human Genome Project on the clinical management of sporadic cancers

Abstract

The publication of the human genome sequence has provided a new basis for cancer research. Molecular analysis of single cancer genes in isolation may lead to an underestimation of the impact of networks of intertwined genes in molecular cancer pathology. However, new technologies such as DNA microarrays or microchips will enable the detection of global gene-expression profiles--already described for lymphomas, acute leukaemias, and various solid tumours--and may help to overcome some of the limitations of gene function analysis. In addition, DNA microchip data banks may uncover new genes that are relevant to the molecular pathology of specific cancers and trigger detailed analysis of their function. Clinically, microchips will enable us to identify new molecular cancer markers or marker profiles of prognostic and predictive value, since global gene-expression patterns can highlight molecular tumour characteristics that relate to clinically distinct entities within heterogeneous cancers, such as non-Hodgkin lymphomas or breast cancer. However, before its promise can be realised, all molecular information stemming from the Human Genome Project will need to be tested for its clinical relevance in appropriate cancer trials; this presents a formidable but important challenge.