Personalized diagnostic and therapeutic strategies in oncology

In our lifetimes we hope to see the genome transform diagnosis and facilitate individualized management of cancer. In the foreseeable future, cancer genomes and transcriptomes will be identified and cataloged, and pathway-specific therapies will continue to be developed. Population-wide databases will be used to assist physicians in guiding patients to the appropriate therapy for their tumor. Already there are early outstanding examples of the successful application of genetic and genomic data to guide cancer therapy. However, truly tailored therapeutics in oncology will require genomic analyses of an individual's tumor as well as a more comprehensive assessment of their genetic background, health, and environment exposures in order to determine the risk of disease, the dose requirements for drugs, and the likelihood of response. Tumor genomics will eventually result in a comprehensive description of cellular processes critical to cancer growth for subsequent therapeutic impact. While there will be significant technical and societal challenges to overcome, the integration of personalized medicine into clinical practice is anticipated by clinicians, expected by patients, and represents the likely future of oncology.