Precision medicine in medical oncology: hope, disappointment and reality

Abstract

During the past 20 years, targeted therapy based on the understanding of tumor biology has been complementing or even replacing cytotoxic agents that have dominated pharmacotherapy of cancer since the conception of medical oncology. Unfortunately, the fact that targeted therapies with potential to induce cure or at least substantially prolong survival are still not available for many common solid tumors results in skepticism or even nihilism. On the one hand, biomarker research is not keeping pace with the introduction of new agents, while on the other hand, effective drugs are still not available for many potential molecular targets associated with malignant transformation and tumor progression. However, targeted therapies have already transformed the natural history and clinical outcomes not only in patients with rare malignancies like gastrointestinal stromal tumor but also with many common tumors, e.g. breast cancer, malignant melanoma, non-small cell lung cancer or renal cell carcinoma. For further advances, a multidisciplinary effort is indispensible that should, above all, involve the collaboration of medical oncology and laboratory medicine.

Bacillus Calmette-Guérin pneumonitis after intravesical instillation: Report of two cases and a review of the literature

“…Immunotherapy may be viewed as a form of targeted therapy aiming at activating the host response against the tumor 1,5 . Conceptually, immunotherapy has an advantage over cytotoxic chemotherapy, the medical treatment most commonly used in cases of malignant disease.…”

“…Conceptually, immunotherapy has an advantage over cytotoxic chemotherapy, the medical treatment most commonly used in cases of malignant disease. It has a different mechanism of action resulting in greater efficacy in certain situation, and relative selectivity that is associated with fewer side effects 5 . Although the administration of immunotherapy is, in general, associated with better tolerance compared to cytotoxic agents, it has a peculiar set of toxicities that is specific for each modality of immunotherapy.…”

NcRNAs: Multi‑angle participation in the regulation of glioma chemotherapy resistance (Review)

“…Tumour-related molecular targeted therapy has become an important research field. In particular, molecular targeted therapy has achieved great success in the treatment of non-small cell lung cancer, malignant melanoma and chronic myeloid leukaemia ( 76 ), findings that have important guiding significance for the application of molecular targeted drugs in the treatment of malignant gliomas. Compared with traditional drugs, molecular targeted drugs are less toxic and only inhibit tumour cells.…”

Managing “Stable” Cancer News

“…Both views are insufficient” (Kleinman, Eisenberg, and Good 1978:140–41). When discordance exists between lay expectations about hoped for outcomes of reduced cancer (Bartoušková and Melichar 2020) and doctors’ treating stable as good news because cancer is not growing, patients’ “disappointment stems from disconfirmed expectancies . .…”

“…Analysis includes a case study of a patient displaying explicit disappointment with stable, including emotional frustrations (e.g., sighing and crying) that expectations for healing have not been realized. By examining interactional moments such as these, opportunities are provided to extend social-psychological concerns with disappointment as an array of emotions (e.g., sadness, worry, anger) experienced primarily by individuals (e.g., see Bartoušková and Melichar 2020;Bell 1982Bell , 1985Zeelenberg et al 2000). Patients exhibit what Sacks (1988Sacks ( /89, 1992 described as different ''measurement systems'' for making sense of normal events.…”