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Published on: July 25, 2020
Cancer Targeted Therapy Strategy: The Pathologist's Perspectives
Lara Alessandrini1, Tiziana Perin1,2, Shahin Kadare3
1Divisions of Pathology, CRO IRCCS National Cancer Institute, Aviano (PN), Italy.
Abstract:
The effectiveness of new personalized treatment procedures in oncology is based on the fact that certain tumors exhibit specific molecular features. More in detail, neoplastic tissues of patients should display a specific biomarker, most often a specific genetic alteration and/or under/overexpression of a definite protein, that could be the target of its respective drug. Immunohistochemical and molecular analyses, which usually include examination of nucleic acids from either tissues or fluids, are common tests to define the status of a tumor. This review focuses on the pathologist's role in carefully controlling pre- analytic procedures and standard operating procedures that are a crucial prerequisite to reach reliable and reproducible results. Six paradigmatic applications of targeted therapy, for which pathological diagnosis plays a fundamental role, are summarized. Traditional and next-generation sequencing are also addressed from the pathologist's perspective as well as the importance pathologists have in this shift to more accurate definition of disease risk and prognostication of therapy response in the personalized medicine era.
Insights
Pathologists ensure accurate personalized cancer treatments by validating molecular biomarkers. Their oversight of pre-analytic procedures is crucial for reliable targeted therapy and improved patient prognostication.
Area of Science:
- Oncology
- Pathology
- Molecular Diagnostics
Background:
- Personalized medicine in oncology relies on specific molecular features of tumors.
- Biomarkers, such as genetic alterations or protein expression, guide targeted drug selection.
- Accurate tumor characterization is essential for effective personalized treatment strategies.
Purpose of the Study:
- To highlight the pathologist's critical role in ensuring the reliability of molecular diagnostics for personalized oncology.
- To review the pathologist's involvement in pre-analytic and standard operating procedures.
- To summarize applications of targeted therapy where pathological diagnosis is fundamental.
Main Methods:
- Review of immunohistochemical and molecular analyses for tumor status definition.
- Examination of nucleic acid analysis from tissues and fluids.
- Discussion of traditional and next-generation sequencing from a pathologist's viewpoint.
Main Results:
- Pathologists play a key role in controlling pre-analytic and standard operating procedures for reliable results.
- Six paradigmatic applications of targeted therapy are summarized, emphasizing the importance of pathological diagnosis.
- The shift towards personalized medicine necessitates pathologist expertise in molecular diagnostics and prognostication.
Conclusions:
- The pathologist's meticulous control over diagnostic procedures is paramount for the success of personalized cancer therapy.
- Accurate pathological assessment is indispensable for identifying appropriate molecular targets and predicting therapy response.
- Pathologists are central to advancing personalized medicine through precise disease definition and prognostication.
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