Editorial: Personalized Medicine for Urological Cancers: Targeting Cancer Metabolism

Abstract

The key concept of personalized medicine is to identify the best treatment possible for a selected patient, in order to maximize therapeutic efficacy, reduce side effects, and minimize the risk of drug resistance development. To achieve this, it is fundamental to define effective cancer classifiers, which would allow appropriate patient stratification, minimizing overtreatment of indolent disease and avoiding delay in therapeutic treatments.Sample availability, intra-tumor heterogeneity and the lack of established models for disease progression, have been the main challenges in deciphering the functional impact of genomic alterations on urological cancers, both in their common or rare forms. However, it has been possible to subtype urological cancers, mainly prostate and bladder, based on genomic alterations, while there is still a lack of knowledge of the metabolome. With the advances in metabolomics, the evaluation of metabolites has emerged as a strategy to identify new biomarkers. As discussed in the review by Singh R. et al. (Singh and Mills), there is a strong contrast between the capacity to sequence at high scale and decode genomic data in contrast with the metabolites that can be currently identified by mass spectrometry or other methods. When the technology can overcome this technical challenge, we will be able to prove the crosstalk between metabolic pathways and other cancer drivers and identify the causative connection of this interplay during disease onset and progression.The aim of this Research Topic is to illustrate examples of personalized medicine for urological cancers, where assessment of metabolism can be used as strategy to refine disease diagnosis and patient prognosis.

Immunosuppressive Signaling Pathways as Targeted Cancer Therapies

“…Molecularly targeted therapies are aimed at targeting these aberrant signatures either by down or upregulation of the genes relevant to a particular disease. Personalized precision medicine is aimed at developing individualized therapeutic strategies that are more effective at treating a specific type of disease with fewer adverse events and reduced therapeutic resistance [125]. Even though there is less toxicity and reduced adverse events compared with chemotherapy, targeted therapies have presented their own drawbacks in this regard.…”