Evolution of precision oncology-guided treatment paradigms.

IF 4.6 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL WIREs Mechanisms of Disease Pub Date : 2023-01-01 DOI:10.1002/wsbm.1585
Ramanuj DasGupta, Aixin Yap, Elena Yong Yaqing, Shumei Chia
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引用次数: 3

Abstract

Cancer treatment is gradually evolving from the classical use of nonspecific cytotoxic drugs targeting generic mechanisms of cell growth and proliferation. Instead, new "patient-specific treatment paradigms" that are based on an individual patient's tumor-specific molecular features are emerging, and these include "druggable" genomic alterations such as oncogenic driver mutations, downstream activities of cancer-signaling pathways, and the expression of specific genes involved in tumorigenesis and cancer progression. This evolving landscape of making evidence-based treatment decisions forms the foundation of precision oncology, which aims to deliver "the right drug, to the right patient and at the right time". The long-term vision for this approach is to maximize the treatment efficacy while minimizing exposure to ineffective therapy and reducing co-morbidity-related side effects. Successful clinical translation and implementation of this vision have the potential to revolutionize treatment paradigms from predominantly reactive, to more evidence-based, proactive and predictive care. In this article, we review the past and current approaches in precision oncology, and describe their remarkable power and limitations. We also speculate on the evolution of newly emerging methodologies of the future that can be used to address some of the key challenges associated with the existing paradigms. This article is categorized under: Cancer > Genetics/Genomics/Epigenetics Cancer > Molecular and Cellular Physiology Cancer > Computational Models.

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精准肿瘤指导治疗模式的演变。
癌症治疗正逐渐从传统的使用非特异性细胞毒性药物来靶向一般的细胞生长和增殖机制演变而来。相反,基于个体患者肿瘤特异性分子特征的新的“患者特异性治疗范式”正在出现,其中包括“可药物”的基因组改变,如致癌驱动突变,癌症信号通路的下游活动,以及参与肿瘤发生和癌症进展的特定基因的表达。这种不断发展的以证据为基础的治疗决策构成了精确肿瘤学的基础,其目标是“在正确的时间给正确的病人提供正确的药物”。这种方法的长期目标是最大限度地提高治疗效果,同时最大限度地减少无效治疗的暴露,并减少与合并症相关的副作用。成功的临床翻译和实施这一愿景有可能彻底改变治疗模式,从主要的被动治疗,到更多的循证、主动和预测性护理。在这篇文章中,我们回顾了过去和现在的精确肿瘤学方法,并描述了它们显著的力量和局限性。我们还推测了未来新出现的方法的演变,这些方法可用于解决与现有范式相关的一些关键挑战。本文分类如下:癌症>遗传学/基因组学/表观遗传学癌症>分子和细胞生理学癌症>计算模型。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
WIREs Mechanisms of Disease
WIREs Mechanisms of Disease MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
11.40
自引率
0.00%
发文量
45
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