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Genomics-driven oncology: framework for an emerging paradigm

Levi A Garraway1

  • 1Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA. levi_garraway@dfci.harvard.edu

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|April 17, 2013
PubMed

Insights

Genomic alterations drive most cancers, but harnessing tumor genetic information is a new frontier. Systematic genomic profiling may improve cancer patient outcomes, pending rigorous evaluation and logistical innovations.

Area of Science:

  • Oncology
  • Genomics
  • Translational Medicine

Background:

  • Most cancers originate from genomic alterations disrupting critical oncogenic pathways.
  • The clinical utility of tumor genetic information is increasingly recognized.
  • Advances in discovery, technology, and therapeutics enable testing of genomics-driven cancer medicine.

Purpose of the Study:

  • To evaluate the hypothesis that systematic tumor genomic profiling improves patient outcomes.
  • To identify necessary innovations for implementing genomics-driven cancer medicine.
  • To determine the integration of comprehensive tumor genomic information into routine cancer care.

Main Methods:

  • Systematic tumor genomic profiling.
  • Advanced data interpretation strategies.
  • Innovative clinical trial designs.
  • Ethical frameworks for returning genetic results.

Main Results:

  • The convergence of discovery, technology, and therapeutics presents an opportunity to test the genomics-driven medicine hypothesis.
  • Rigorous evaluation is required to validate the clinical benefits of comprehensive tumor genomic information.
  • Logistical and conceptual innovations are essential for successful implementation.

Conclusions:

  • The hypothesis that systematic knowledge of individual tumor genomic information can improve clinical outcomes requires rigorous validation.
  • Successful integration of comprehensive tumor genomic information into routine care depends on logistical innovations and robust evaluation.
  • The future of cancer care may be significantly shaped by the effective implementation of genomics-driven strategies.

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