Precision Medicine in Hematologic Malignancies: Evolving Concepts and Clinical Applications

Area of Science:

• Hematologic Oncology
• Genomics
• Precision Medicine

Background:

• Precision medicine revolutionizes hematologic cancer care, shifting from "one-size-fits-all" to individualized treatment strategies.
• Molecular profiling technologies are fundamental to this paradigm shift in hematology.

Purpose of the Study:

• To review foundational technologies, disease-specific advances, and emerging directions in precision hematology.
• To highlight key molecular targets and personalized strategies for various hematologic malignancies.

Main Methods:

• Utilizes molecular profiling techniques like next-generation sequencing (NGS), whole-exome sequencing (WES), and RNA sequencing (RNA-seq).
• Incorporates epigenomic, proteomic analyses, liquid biopsy, and minimal residual disease (MRD) monitoring.
• Discusses specific targets (e.g., FLT3, IDH1/2, BCR-ABL1, TP53, BCMA) and strategies across leukemias, lymphomas, and myeloma.

Main Results:

• Identifies major molecular targets and personalized strategies for AML, ALL, CML, CLL, lymphomas, and multiple myeloma.
• Highlights progress in diagnosis, risk stratification, and therapeutic decision-making through advanced tools.
• Acknowledges persistent challenges including cost, access disparities, standardization, and clinical integration.

Conclusions:

• Advances in single-cell sequencing, immunotherapies, and AI offer promising future directions for refining treatment and improving outcomes.
• Overcoming implementation barriers is crucial for equitable and widespread adoption of precision medicine in hematologic oncology.