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Review
. 2022 May 9;40(5):458-478.
doi: 10.1016/j.ccell.2022.04.002. Epub 2022 Apr 28.

The translational challenges of precision oncology

Oriol Pich  1 , Chris Bailey  1 , Thomas B K Watkins  1 , Simone Zaccaria  2 , Mariam Jamal-Hanjani  3 , Charles Swanton  4
Affiliations
Free article
Review

The translational challenges of precision oncology

Oriol Pich et al. Cancer Cell. .
Free article

Abstract

The translational challenges in the field of precision oncology are in part related to the biological complexity and diversity of this disease. Technological advances in genomics have facilitated large sequencing efforts and discoveries that have further supported this notion. In this review, we reflect on the impact of these discoveries on our understanding of several concepts: cancer initiation, cancer prevention, early detection, adjuvant therapy and minimal residual disease monitoring, cancer drug resistance, and cancer evolution in metastasis. We discuss key areas of focus for improving cancer outcomes, from biological insights to clinical application, and suggest where the development of these technologies will lead us. Finally, we discuss practical challenges to the wider adoption of molecular profiling in the clinic and the need for robust translational infrastructure.

Keywords: cancer evolution; cancer genomics; drug resistance.

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Conflict of interest statement

Declaration of interests C.S. acknowledges grant support from Pfizer, AstraZeneca, Bristol Myers Squibb, Roche-Ventana, Boehringer-Ingelheim, Invitae (previously Archer Dx Inc.)-collaboration in minimal residual disease sequencing technologies, and Ono Pharmaceutical and is an AstraZeneca Advisory Board member and Chief Investigator for the AZ MeRmaiD1 and two clinical trials. C.S. is also chief investigator of the NHS Galleri trial and has consulted for Amgen, Pfizer, Novartis, GlaxoSmithKline, MSD, Bristol Myers Squibb, Celgene, AstraZeneca, Illumina, Genentech, Roche-Ventana, GRAIL, Medicxi, Metabomed, Bicycle Therapeutics, Roche Innovation Center Shanghai, and the Sarah Cannon Research Institute. C.S. had stock options in Apogen Biotechnologies and GRAIL until June 2021, has stock options in Epic Bioscience, Bicycle Therapeutics and has stock options and is co-founder of Achilles Therapeutics. M.J.-H. has consulted and is a member of the Scientific Advisory Board and Steering Committee for Achilles Therapeutics, has received speaker honoraria from Astex Pharmaceuticals, and holds a patent PCT/US2017/028,013 relating to methods for lung cancer detection. C.S. holds European patents relating to assay technology to detect tumor recurrence (PCT/GB2017/053,289), target neoantigens (PCT/EP2016/059,401), identify patent response to immune checkpoint blockade (PCT/EP2016/071,471), determine HLA LOH (PCT/GB2018/052,004), predict survival rates of patients with cancer (PCT/GB2020/050,221), and identify patients who respond to cancer treatment (PCT/GB2018/051,912); a US patent relating to detecting tumor mutations (PCT/US2017/28,013); and both European and US patents related to identifying insertion and deletion mutation targets (PCT/GB2018/051,892). The other authors declare no competing interests.

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