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The future of cancer treatment is precision medicine

Lung Cancer Cell DivisionCredit: arinarici/iStock/Getty Images

Although cancer treatments have improved drastically over the past decade, many cancers can adapt to evade therapeutic drugs. To develop more effective cancer treatments, researchers strive to understand how cancers evolve and interact with other cells in their environment, so they can tailor therapies to individual patients in a process called precision medicine. Trever Bivona describes outstanding challenges in cancer biology, his research programme, and his role as editor-in-chief of npj Precision Oncology, an online open-access journal in partnership with The Hormel Institute at the University of Minnesota.

Trever Bivona, Editor-in-chief of npj Precision Oncology

What are the biggest challenges in cancer biology?

Most cancers are treated with individual drugs, which has been successful to a point, but eventually cancers find a way around them. One big challenge in the field of cancer biology is understanding how cancers evolve, adapt, and start to grow again after evading a particular drug. This often involves additional mutations or alterations in the signal transduction pathways of cancers. Another challenge is understanding the interactions between cancer cells and the cells in their surrounding environment. Studies have either focused on signal transduction in cancer cells or T cells and macrophages in cancers. Now the key is to bring that molecular and cell biology information together in a synthetic way to understand tumours as an ecosystem — critical for developing combinations of drugs that might be able to keep cancers at bay and transform them into more manageable chronic diseases.

What is the focus of your research programme?

My research centres on the molecular and cell biology of cancer, with a particular focus on the signal transduction pathways that go awry in cancers. These pathways are in cancer cells, so they’re turned on too much or, in some cases, turned off too much, driving cancer cell proliferation, growth, metastasis, and treatment resistance. Understanding the workings of signal transduction pathways both in normal cells as well as in cancer cells unlocks the potential to understand the basis for cancer and intervene strategically to target certain parts of these pathways to develop effective and safe treatments. We are also exploring how cancer cells interact and evolve with other surrounding cell types in the tumour ecosystem to identify complementary ways to treat tumours. Studying disease such as cancer often provides insight into how things function normally to offer fundamental biological discoveries as well.

How does precision medicine play a role in treating cancers?

Precision medicine involves using deep knowledge of disease pathogenesis to tailor therapy to an individual patient or a set of patients that appear to be alike based on their tumour characteristics. This could involve identifying a particular mutation in the DNA that’s causing the cancer or using computational approaches, digital medicine, or artificial intelligence to understand features of the cancer that might make it more or less aggressive. Precision medicine takes a broad approach to uncover detailed features of a particular cancer that can be used to better manage care.

What is the scope of npj Precision Oncology?

There’s a lot that can fit under the precision oncology umbrella. A core tenet of the papers we publish is that they have a molecular or mechanistic foundation to their research, and combine that with other important tumour features. That could apply more broadly to artificial intelligence (AI) and deep- learning based approaches or epidemiological studies, for example, in addition to the more conventional arena of molecular medicine. We publish review articles on hot topics and big challenges in the field. We also publish editorials on important research articles and thematic issues on particular research areas, such as cancer immunotherapy or the AI revolution in cancer. In 2021, we plan to begin publishing meeting summaries that include a brief background on the conference and some of the key findings.

What are your goals for npj Precision Oncology?

I would like to make the journal a trusted source for the field of precision oncology, whether that’s a new molecular mechanism, a new treatment, or an AI-based approach that might have merit. I would like the scientific community to think of us as the go-to forum for submitting manuscripts and reading articles with a precision oncology focus. That starts with publishing the highest- level science and establishing a reputation for being a source of cutting-edge information in the field.

I also want to engage the precision oncology research community to understand their needs and what kind of journal they’re interested in. We have an opportunity to not just impose our own vision internally, but also to let the research field shape the journal. We want the journal to foster global interactions and have a global impact. Our editorial team represents leaders in the field and rising stars from the United States, France, the UK, Saudi Arabia, Japan, and several other regions. Now more than ever we need forums where we can come together and collaborate across different institutions in all parts of the world. I view npj Precision Oncology as one such important dynamic and interactive forum.

To learn more about the Hormel Institute and the work they are doing, click here.


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