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Challenging Standard-of-Care Paradigms in the Precision Oncology Era
Vivek Subbiah1, Razelle Kurzrock2
1Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
Abstract:
The pace of genomic and immunological breakthroughs in oncology is accelerating, making it likely that large randomized trials will increasingly become outdated before their completion. Traditional clinical research/practice paradigms must adapt to the reality unveiled by genomics, especially the need for customized drug combinations, rather than one-size-fits-all monotherapy. The raison-d'être of precision oncology is to offer 'the right drug for the right patient at the right time', a process enabled by transformative tissue and blood-based genomic technologies. Genomically targeted therapies are most suitable in early disease, when molecular heterogeneity is less pronounced, while immunotherapy is most effective against tumors with unstable genomes. Next-generation cancer research/practice models will need to overcome the tyranny of tradition and emphasize an innovative, precise and personalized patient-centric approach.
Insights
Genomic advances in oncology necessitate personalized medicine, moving beyond traditional trials. Precision oncology uses genomic technologies to tailor treatments for better patient outcomes.
Area of Science:
- Oncology
- Genomics
- Immunology
Background:
- Genomic and immunological research in cancer is rapidly advancing.
- Traditional large randomized trials may become outdated before completion due to accelerated discoveries.
- Current research paradigms must adapt to genomic insights, favoring customized drug combinations over monotherapy.
Purpose of the Study:
- To highlight the need for adapting traditional clinical research and practice models in oncology.
- To emphasize the role of precision oncology in delivering personalized patient care.
- To discuss the integration of genomic technologies in cancer treatment strategies.
Main Methods:
- Genomic and immunological breakthroughs are driving changes in oncology.
- Tissue and blood-based genomic technologies enable personalized medicine.
- Analysis of treatment suitability based on genomic profiles and disease stage.
Main Results:
- Precision oncology aims to match the right drug to the right patient at the right time.
- Genomically targeted therapies are effective in early-stage disease with less molecular heterogeneity.
- Immunotherapy shows efficacy in tumors with unstable genomes.
Conclusions:
- Next-generation cancer research and practice models require a shift from traditional approaches.
- An innovative, precise, and personalized patient-centric strategy is essential.
- Overcoming traditional constraints is key to advancing precision oncology.
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