title: Precision Medicine and Non-Colorectal Cancer Liver Metastases: Fiction or Reality?
abstract: BACKGROUND
  Non-colorectal liver metastases (nCRLM) constitute a variety of heterogeneous diseases and a considerable therapeutic challenge. Management is based on the primary tumor and the clinical course. In the era of precision medicine (PM) we know that cancer is heterogeneous within the tumor and across different sites.
  
  
  METHODS
  We give an overview of the path to PM through 'omics' beyond genomics. We refer to the experience gained to date from models such as colorectal cancer and we discuss the opportunity offered by PM for the management of nCRLM.
  
  
  RESULTS
  In order to best characterize and track tumor biological behaviors as well as to understand mechanisms of response to therapy and survival we suggest the application of novel clinical trial designs, a dynamic approach with serial monitoring involving evaluation of primary and metastatic sites. Quality and standardization of tissue acquisition and biobanking is a precondition for the reliability of this approach.
  
  
  CONCLUSIONS
  The application of PM is increasingly becoming a reality. Elucidating the mysteries of tumors in complex settings can only be achieved with the approach PM offers. nCRLM may serve as a model for the application of PM principles and techniques in understanding individual diseases and also cancer as an entity and therapeutic challenge.
authors.affiliation: Division of Hematology, University of Washington, Seattle, WA, USA.
authors.forename: Effie
authors.initials: E
authors.lastname: Liakopoulou
authors.affiliation: National Center for Cancer Care & Research, Cancer Services, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Alexander
authors.initials: A
authors.lastname: Knuth
keywords: Clinical trials; Immune oncology; Liver metastases; Non-colorectal cancer; Precision medicine