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The full genome sequence of a rare tongue tumour has allowed physicians to draw up a personalized treatment plan where no established protocol existed.

A 78-year-old patient had his cancer sequenced after initial treatments failed to slow tumour growth, which had spread to his lungs. When Steven Jones of the British Columbia Cancer Agency in Vancouver, Canada, and his colleagues analysed the sequence and compared it with that of his normal cells, they determined that tumour growth was probably driven by overexpression of a cancer-promoting gene called RET.

A combination of drugs that target RET held back the cancer for seven months, until the tumours became drug-resistant. The team sequenced the cancer again and identified new mutations that had activated the AKT and MAPK pathways, which are often upregulated in cancer. The results provide a snapshot of how tumours evolve to evade treatment.

Genome Biol. 11, R82 (2010)