A Paradigm Shift in Cancer Treatment: Genomics and Precision Medicine
A new approach is being taken to treat cancer, where patients will be given personalized, gene-directed treatment based on biomarker analysis. This is a result of the rapidly expanding knowledge on the roles of genomics and the immune system in cancer, allowing for the development of therapies that specifically target molecular alterations and immune suppression.
This shift in the therapy paradigm is causing innovative changes in clinical trial designs. Traditionally, trials have been focused on identifying common attributes among patients and enrolling them in a trial with a specific drug regimen. However, the variability in genomic subgroups, microenvironment, and other characteristics has led to the need for personalized treatment based on individual biomarkers.
The cornerstone of precision medicine studies has been genomics, although RNA and protein profiles have also played important roles in these studies. For example, cell-free DNA testing and analysis of circulating tumor cells (CTCs) derived from blood have been increasingly used to select cancer therapies and monitor tumor dynamics during treatment.
Immunotherapy has also represented a great advance in oncology, reactivating the innate immune response against tumors. This has led to the development of several novel approaches, such as checkpoint blockade and cellular therapy. Seven FDA-approved checkpoint inhibitors have been identified, with selected patients showing a notable response, including durable complete remission.
The emergence of these innovative changes in cancer treatment signifies a new era of precision medicine in oncology, providing patients with the opportunity for personalized and effective compatible therapy early in the disease course.