On the Individualized Cancer Management

Abstract

Individualized cancer management is the opposite of the standardized care adapted for current clinical practice by the mainstream medicine. It is not a fancy concept but a logic and inevitable reality derived from the intrinsic characteristics of cancer and host antitumor response. The question is not whether it should be done but how it is done. Previous efforts have identified various cancer driver gene mutations in individual cancer patient, which have provided basis for treating different patients with different drugs that target various mutated kinases that drive tumor replication. This progress has made one step towards individualized cancer management with limited success in the past two decades in certain type of cancer. A much larger step awaits to be made towards true individualized management of cancer. This step is based on the individual differences in antitumor immunity in different cancer patients. Because antitumor immunity is the most impacting factor for cancer survival once the malignancy of a tumor is established, to fully recognize and utilize this force in the battle against cancer maximize patient survival to the theoretical limit. A true individualized cancer therapy is not only based on personal situation for each patient, but must also satisfy the criterion that the outcome of selected therapy is predictable for that patient, a feature that current standardized care does not have. Thus, treating each patient according to the status of his antitumor immunity should be the most critical skills a physician needs to master when facing each individual cancer patient. In the past nine years, we have been exploring individualized management of cancer through recognizing and manipulating antitumor immunity in each patient. Our combined experiences indicate a significant benefit to patient survival with reduced costs even when such effort was not perfect in the past. With time and more learning, we see this practice becoming more and more practical in a clinical setting. When this individualized approach becomes guideline for cancer management, we will see a significant leap of clinical improvement on both patient survival and cancer cure rate.