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Overcoming implementation challenges of personalized cancer therapy

Nature Reviews Clinical Oncology volume 9, pages 542–548 (2012)Cite this article

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Abstract

Personalized cancer therapy is based on the precept that detailed molecular characterization of the patient's tumour and its microenvironment will enable tailored therapies to improve outcomes and decrease toxicity. The goal of personalized therapy is to target aberrations that drive tumour growth and survival, by administering the right drug combination for the right person. This is becoming increasingly achievable with advances in high-throughput technologies to characterize tumours and the expanding repertoire of molecularly targeted therapies. However, there are numerous challenges that need to be surpassed before delivering on the promise of personalized cancer therapy. These include tumour heterogeneity and molecular evolution, costs and potential morbidity of biopsies, lack of effective drugs against most genomic aberrations, technical limitations of molecular tests, and reimbursement and regulatory hurdles. Critically, the 'hype' surrounding personalized cancer therapy must be tempered with realistic expectations, which, today, encompass increased survival times for only a portion of patients.

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Figure 1: Tumour heterogeneity.
Figure 2: Approaches to tumour heterogeneity and molecular evolution.

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Acknowledgements

We thank Ruth Haynes for assistance with the manuscript preparation.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1484, Houston, 77030, TX, USA

    Funda Meric-Bernstam

  2. Department of Systems Biology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1484, Houston, 77030, TX, USA

    Gordon B. Mills

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All authors made a substantial contribution to researching data for the article, discussing content, and writing and editing the manuscript prior to submission, and revising the article after peer review.

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Correspondence to Funda Meric-Bernstam.

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Competing interests

G. B. Mills declares he is a consultant and he serves as a scientific advisor of Arcxis Biotechnologies, Asuragen, Catena Pharmaceuticals, Daiichi-Sankyo, Foundation Medicine, Komen Foundation, Novartis, Targeted Molecular Diagnostics LLC, Tau Therapeutics. He owns shares from Catena Pharmaceuticals, PTV Sciences. He receives grant support from Astrazeneca, Celgene, CeMines Inc, Exelisis, GlaxoSmithKline, Lpath Inc, Pfizer, Roche. F. Meric-Bernstam declares no competing interests.

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Meric-Bernstam, F., Mills, G. Overcoming implementation challenges of personalized cancer therapy. Nat Rev Clin Oncol 9, 542–548 (2012). https://doi.org/10.1038/nrclinonc.2012.127

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