Precision Oncology: Three Small Steps Forward

Abstract

Only a subset of cancer patients currently benefit from personalized treatment approaches. Detection of actionable drug targets in cell-free DNA, more comprehensive molecular profiling integrating transcriptional analyses, and personalized combination regimens all hold promise in expanding the benefits of personalized oncology to larger numbers of cancer patients.

Figure 1.. Potentially Actionable Alterations Are Associated with Different Likelihoods of Clinical Response

For most targeted therapies, drug sensitivity varies as a function of both cancer type and the specific mutant allele present. Future matching algorithms should give varying weight to alterations based on these factors, with compelling clinical evidence in the patient’s specific disease type and mutant allele conferring the greatest weight. A primarly limitation of current cancer precision paradigms is that few alterations identified by clinical tumor profiling are predictive of drug response based on compelling clinical data generated in the context of the patient’s specific mutant allele and disease type.