Transforming Cancer Prevention through Precision Medicine and Immune-oncology

Area of Science:

• Oncology
• Genomics
• Immunology

Background:

• Cancer prevention is rapidly advancing due to breakthroughs in precision medicine and immune-oncology.
• Recent progress in genome sequencing, big data, blood-based tests, and understanding the tumor immune microenvironment (TME) offers new ways to study premalignancy.

Purpose of the Study:

• To highlight recent advances and outline a future agenda for cancer prevention research.
• To emphasize the integration of precision medicine and immunoprevention for personalized public health.

Main Methods:

• Analysis of recent clinical firsts and research findings in cancer prevention.
• Review of technological advancements including genome-wide sequencing, big-data analytics, and blood-based technologies.
• Investigation of the tumor immune microenvironment (TME) and its role in premalignant progression.

Main Results:

• Driver mutations in cell-free DNA detected in premalignant lesions (lung).
• Clonal hematopoiesis identified as a premalignant state.
• Successful chemoprevention trials using targeted therapies and combination treatments.
• Validation of early detection markers for lung cancer and promise for other cancers.
• HPV identified as a key cause of cancer, enabling public health interventions.
• Association of genetic drivers with immunosuppressive TME and efficacy of Kras vaccine in mouse models.
• Repurposed drugs like aspirin, metformin, and tamoxifen show immune activity.

Conclusions:

• Precision medicine and immune-oncology are transforming cancer prevention, mirroring their impact on cancer therapy.
• Future cancer prevention research should focus on integrating precision medicine and immunoprevention.
• A 'Pre-Cancer Genome Atlas' (PCGA) is proposed as a future research initiative.