title: Unique molecular landscapes in cancer: implications for individualized, curated drug combinations.
abstract: With increasingly sophisticated technologies in molecular biology and "omic" platforms to analyze patients' tumors, more molecular diversity and complexity in cancer are being observed. Recently, we noted unique genomic profiles in a group of patients with metastatic breast cancer based on an analysis with next-generation sequencing. Among 57 consecutive patients, no two had the same molecular portfolio. Applied genomics therefore appears to represent a disruptive innovation in that it unveils a heterogeneity to metastatic cancer that may be ill-suited to canonical clinical trials and practice paradigms. Upon recognizing that patients have unique tumor landscapes, it is possible that there may be a "mismatch" between our traditional clinical trials system that selects patients based on common characteristics to evaluate a drug (drug-centric approach) and optimal treatment based on curated, individualized drug combinations for each patient (patient-centric approach).
authors.affiliation: Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas. jjwheler@mdanderson.org.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wheler
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: J Jack
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Division of Hematology and Oncology, Center for Personalized Cancer Therapy, University of California San Diego Moores Cancer Center, San Diego, California.
authors.forename: Razelle
authors.initials: R
authors.lastname: Kurzrock
mesh_terms: D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D004338:Drug Combinations; D005260:Female; D020869:Gene Expression Profiling; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D057285:Precision Medicine; D040901:Proteomics
chemical_list: D004338:Drug Combinations