From Cancer Genomics to Precision Oncology—Tissue’s Still an Issue

Abstract

Rapidly evolving genome technology has enabled extensive molecular analysis of limited tumor biopsy material, thereby facilitating the broader implementation of personalized cancer medicine. However, genomics-based patient stratification across diverse tumor types is unlikely to supplant tissue-of-origin considerations in addressing clinical needs, including the development and application of novel "rationally targeted" cancer therapies.

DNA-Guided Precision Medicine for Cancer: A Case of Irrational Exuberance?

“…That the genotype alone may not predict drug responses reliably suggests that the tissue in which the cancer mutation occurs can be a major factor in determining response to therapy (8). As one example, BRAF V600E -mutant colon cancers have modest responses to BRAF inhibition compared to melanomas harboring the same oncogenic driver mutation (9,10).…”

The Impact of Research on the Future of Dental Education: How Research and Innovation Shape Dental Education and the Dental Profession

“…OSCC-associated morbidity and mortality remain high and have not improved in over four decades. [61][62][63][64] One explanation for the lack of improvement relates to tumor size: lymph node involvement and stage (I to IV) do not provide guidance for clinical outcome. Apart from tobacco, alcohol, and direct sunlight, human papilloma virus (HPV) infection is another known risk factor for OSCC.…”

“…In addition, the standards in virtually every state in the U.S. have failed to keep pace with changes in the biological sciences, especially genomics, including omitting concepts related to genetic complexity, the importance of environment to phenotype variation, differential gene expression, and the differences between inherited and somatic genetic diseases. 22,[26][27][28][32][33][34][35][36][37][38][39][55][56][57][58][59][60][61][62][63][78][79][80][81][82][83][84] A multidisciplinary analysis of primary health care recommends that medical, dental, pharmacy, and nursing professional education must be revised and aligned to address interprofessional clinical care approaches to prevention as well as diseases and disorders found in the greater society. [82][83][84] In addition, making significant improvement in the public's craniofacial-oral-dental health will require major revisions in dental education.…”

Evidence of drug-response heterogeneity rapidly generated from a single cancer cell

“…The advance of the technology to sequence the whole genome of a single cell has further unraveled the heterogenic nature of cancer cells [11, 12]. The intratumoral heterogeneity confounds significantly cancer therapy and is a challenge for precision medicine [13]. …”