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An Integrated Platform for Genome-wide Mapping of Chromatin States Using High-throughput ChIP-sequencing in Tumor Tissues
Published on: April 5, 2018
Genetic Mutations and Epigenetic Modifications: Driving Cancer and Informing Precision Medicine
Krysta Mila Coyle1, Jeanette E Boudreau1,2, Paola Marcato1,2
1Department of Pathology, Dalhousie University, Halifax, NS, Canada.
Abstract:
Cancer treatment is undergoing a significant revolution from "one-size-fits-all" cytotoxic therapies to tailored approaches that precisely target molecular alterations. Precision strategies for drug development and patient stratification, based on the molecular features of tumors, are the next logical step in a long history of approaches to cancer therapy. In this review, we discuss the history of cancer treatment from generic natural extracts and radical surgical procedures to site-specific and combinatorial treatment regimens, which have incrementally improved patient outcomes. We discuss the related contributions of genetics and epigenetics to cancer progression and the response to targeted therapies and identify challenges and opportunities for the success of precision medicine. The identification of patients who will benefit from targeted therapies is more complex than simply identifying patients whose tumors harbour the targeted aberration, and intratumoral heterogeneity makes it difficult to determine if a precision therapy is successful during treatment. This heterogeneity enables tumors to develop resistance to targeted approaches; therefore, the rational combination of therapeutic agents will limit the threat of acquired resistance to therapeutic success. By incorporating the view of malignant transformation modulated by networks of genetic and epigenetic interactions, molecular strategies will enable precision medicine for effective treatment across cancer subtypes.
Insights
Precision medicine revolutionizes cancer care by targeting molecular alterations, moving beyond generic treatments. Combining therapies addresses tumor heterogeneity and resistance, improving outcomes across cancer subtypes.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Cancer treatment evolved from cytotoxic therapies to molecularly targeted approaches.
- Precision medicine utilizes tumor molecular features for drug development and patient stratification.
- Understanding genetic and epigenetic factors is crucial for cancer progression and treatment response.
Purpose of the Study:
- To review the historical evolution of cancer treatment strategies.
- To discuss the role of genetics and epigenetics in cancer progression and targeted therapy response.
- To identify challenges and opportunities for successful precision medicine implementation.
Main Methods:
- Literature review of cancer treatment history.
- Analysis of genetic and epigenetic contributions to cancer.
- Discussion of intratumoral heterogeneity and therapeutic resistance mechanisms.
Main Results:
- Tumor molecular profiling enables tailored cancer therapies.
- Intratumoral heterogeneity poses challenges for treatment efficacy and resistance.
- Rational combination of therapies is essential to overcome acquired resistance.
Conclusions:
- Precision medicine offers improved outcomes by targeting specific molecular alterations.
- Addressing tumor heterogeneity and resistance is key for advancing targeted cancer therapies.
- Integrating genetic and epigenetic insights facilitates effective precision medicine across cancer subtypes.
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