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All Patients are Different Patients, and It May Be Time to Treat Them That Way

Rishabh Gaur - Oncology Department Editor





The article “Precision oncology in advanced cancer patients improves overall survival with lower weekly healthcare costs” by Haslem et al. compares the benefits of targeted precision oncology treatment versus standard care. The authors make a case that targeted therapy provides cheaper and more effective care compared to traditional care. The targeted therapy was specific to the individuals' genomic profiling, and the care for the control group was standard care based on their disease type. The article states that overall survival and weekly cost of care improved for the patients receiving targeted therapy, although they did have a higher upfront prescription drug cost. This field of precision oncology is still relatively new, so we must research how to best apply this treatment using next-generation genomic sequencing.

In precision oncology, doctors identify genetic mutations and molecular characteristics of a tumor, and then they treat the cancer with different therapies based on that specific tumor. There are many ways to identify these characteristics, including genomic sequencing to analyze DNA mutations, proteomics to find certain proteins produced by cancer cells, and metabolomics, which involves analyzing cancer cells’ metabolic activity for potential treatment targets. This can be beneficial because the treatment can have fewer side effects than traditional chemotherapy or radiation therapy. For example, in many cases of chronic myeloid leukemia, a specific mutation makes a specific protein, and a drug called imatinib can be used to inhibit this protein. Another example is the mutated BRAF gene in melanoma patients that can be blocked using targeted therapies to reduce the tumor size. The future of cancer treatment may be in personalized medicine, where every patient is treated differently based on their unique condition and genetics.



References

Haslem, D. S., Chakravarty, I., Fulde, G., Gilbert, H., Tudor, B. P., Lin, K., Ford, J. M., &

Nadauld, L. D. (2018). Precision oncology in advanced cancer patients improves overall

survival with lower weekly healthcare costs. Oncotarget, 9(15), 12316–12322.

https://doi.org/10.18632/oncotarget.24384



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