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Utilizing Human Genetics to Develop Chemoprevention for Cancer-Too Good an Opportunity to be Missed

Ulrike Peters¹, Ian Tomlinson²

¹Public Health Sciences Division, Fred Hutchinson Cancer Center and Department of Epidemiology, University of Washington, Seattle, Washington.

Cancer Prevention Research (Philadelphia, Pa.)

|January 4, 2024

Abstract:

Large-scale genetic studies are reliably identifying many risk factors for disease in the general population. Several of these genetic risk factors encode potential drug targets, and genetics has already helped to introduce targeted agents for some diseases, an example being lipid-lowering drugs to reduce the incidence of cardiovascular disease. Multiple drugs have been developed to treat cancers based on somatic mutations and genomics, but in stark contrast, there seems to be a reluctance to use germline genetic data to develop drugs to prevent malignancy, despite the large numbers of people who could benefit, the potential for lowering cancer rates, and the widespread current use of non-pharmaceutical measures to reduce cancer risk factors such as tobacco, alcohol, and infectious diseases. We argue that concerted efforts for cancer prevention based on genetics, including genes influenced by common polymorphisms that modulate cancer risk, are urgently needed. There are enormous, yet underutilized, opportunities to develop novel targeted agents for chemoprevention of cancer based on human germline genetics. Such efforts are likely to require the support of a dedicated funding program by national and international agencies. See related commentary by Winham and Sherman, p. 13.

Insights

Genomic research identifies disease risk factors, yet germline genetics are underused for cancer prevention drug development. Harnessing this data offers significant opportunities for targeted cancer chemoprevention.

Area of Science:

Genetics
Oncology
Pharmacology

Background:

Large-scale genetic studies identify numerous disease risk factors in populations.
Genetic information has informed drug development for conditions like cardiovascular disease and cancers (based on somatic mutations).
There is a notable reluctance to leverage germline genetic data for developing cancer prevention drugs.

Purpose of the Study:

To advocate for the urgent need to develop targeted cancer chemoprevention strategies based on human germline genetics.
To highlight the underutilized potential of germline genetic data for reducing cancer incidence.
To emphasize the parallels with existing non-pharmaceutical cancer risk reduction measures.

Main Methods:

Review of current practices in genetic studies and drug development.
Analysis of the gap between somatic mutation-based cancer drug development and germline genetics for prevention.
Argument for a paradigm shift towards germline genetics in cancer chemoprevention research.

Main Results:

Germline genetic variations, including common polymorphisms, significantly modulate cancer risk.
Numerous potential drug targets for cancer prevention exist within human germline genetics.
Current efforts in germline genetics-based cancer prevention are insufficient despite high potential.

Conclusions:

Concerted efforts are urgently needed to develop targeted cancer prevention agents using germline genetics.
Significant opportunities exist for novel chemoprevention strategies informed by germline genetic data.
Dedicated funding from national and international agencies is likely required to advance this field.

Read full analysis

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