Personalized cancer medicine: molecular diagnostics, predictive biomarkers, and drug resistance.
The progressive elucidation of the molecular pathogenesis of cancer has fueled the rational development of targeted drugs for patient populations stratified by genetic characteristics. Here we discuss general challenges relating to molecular diagnostics and describe predictive biomarkers for personalized cancer medicine. We also highlight resistance mechanisms for epidermal growth factor receptor (EGFR) kinase inhibitors in lung cancer. We envisage a future requiring the use of longitudinal genome sequencing and other omics technologies alongside combinatorial treatment to overcome cellular and molecular heterogeneity and prevent resistance caused by clonal evolution.
Molecular Diagnostics Department, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, UK.
D
D
Gonzalez de Castro
P A
PA
Clarke
B
B
Al-Lazikani
P
P
Workman
D014408:Biomarkers, Tumor / Q000032:analysis*; D019008:Drug Resistance, Neoplasm; D006801:Humans; D008495:Medical Oncology; D009369:Neoplasms / Q000188:drug therapy*; D057089:Pathology, Molecular; D057285:Precision Medicine; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors
D014408:Biomarkers, Tumor; D047428:Protein Kinase Inhibitors; D048493:Proto-Oncogene Proteins B-raf