Review Article

Precision oncology in the age of integrative genomics

  • Nature Biotechnology volume 36, pages 4660 (2018)
  • doi:10.1038/nbt.4017
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Abstract

Precision oncology applies genomic and other molecular analyses of tumor biopsies to improve the diagnosis and treatment of cancers. In addition to identifying therapeutic options, precision oncology tracks the response of a tumor to an intervention at the molecular level and detects drug resistance and the mechanisms by which it occurs. Integrative genomics can include sequencing specific panels of genes, exomes, or the entire triad of the patient's germline, tumor exome, and tumor transcriptome. Although the capabilities of sequencing technologies continue to improve, widespread adoption of genomics-driven precision oncology in the clinic has been held back by logistical, regulatory, financial, and ethical considerations. Nevertheless, integrative clinical sequencing programs applied at the point of care have the potential to improve the clinical management of cancer patients.

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Acknowledgements

This work was supported in part by the NIH Early Detection Research Network Award U01 CA214170, the NIH Clinical Sequencing Exploratory Research (CSER) Award NIH 1UM1HG006508, a Prostate SPORE Award P50 CA186786, and awards from the Prostate Cancer Foundation. A.M.C. is an American Cancer Society Research Professor, a Howard Hughes Medical Institute Investigator, and a Taubman Scholar of the University of Michigan. We thank S. Ellison, scientific writer, for editorial help with the manuscript and R. Kunkel for figure artwork. Helpful discussions with the members of the MI_Oncoseq team including D. Robinson, R. Lonigro, M. Cieslik, Y.-M. Wu, S.M. Dhanasekaran, P. Vats, and X. Cao are gratefully acknowledged.

Author information

Affiliations

  1. Michigan Center for Translational Pathology, Ann Arbor, Michigan, USA.

    • Chandan Kumar-Sinha
    •  & Arul M Chinnaiyan
  2. Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA.

    • Chandan Kumar-Sinha
    •  & Arul M Chinnaiyan
  3. Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA.

    • Arul M Chinnaiyan
  4. Howard Hughes Medical Institute, University of Michigan Medical School, Ann Arbor, Michigan, USA.

    • Arul M Chinnaiyan
  5. Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.

    • Arul M Chinnaiyan
  6. Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, USA.

    • Arul M Chinnaiyan

Authors

  1. Search for Chandan Kumar-Sinha in:

  2. Search for Arul M Chinnaiyan in:

Competing interests

A.M.C. currently serves on the scientific advisory board of Tempus.

Corresponding authors

Correspondence to Chandan Kumar-Sinha or Arul M Chinnaiyan.

Supplementary information

PDF files

  1. 1.

    Supplementary References

    References for Figure 1

Excel files

  1. 1.

    Supplementary Table 1

    Summary of actionable germline aberrations in cancer predisposition genes

  2. 2.

    Supplementary Table 2a and 2b

    A. Germline aberrations currently in clinical trials. Summary of actionable somatic aberrations in cancer genes.