Anti-cancer therapy has historically been developed for specific tumour types that are thought to be dependent, at least in part, on the biological mechanism targeted by that therapy [1]. In contrast, precision medicine matches the unique genomic features of an individual cancer that is determined by genomic profiling with genomically-matched targeted therapies [2, 3].
As the near complete characterisation of the genomic and molecular basis of all common and many uncommon cancers is available, it is now understood that cancers emerge from common germline and somatic genetic changes [4, 5]. Thus, the evidence for new drug approvals is increasingly likely to come from small patient groups with diverse tumour types and a common genomic event, also known as ‘basket trials’ [5, 6].
The identification of common somatic genetic changes across cancers has led to the possibility of using therapies that are independent of tumour histology. This is also referred to as tumour-agnostic treatments [4, 5, 7].
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References
- Yan L, Zhang W. Precision medicine becomes reality-tumor type-agnostic therapy. Cancer Commun (Lond) 2018; 38: 6.
- Luoh SW, Flaherty KT. When Tissue Is No Longer the Issue: Tissue-Agnostic Cancer Therapy Comes of Age. Ann Intern Med 2018; 169: 233-239.
- Hyman DM, Taylor BS, Baselga J. Implementing Genome-Driven Oncology. Cell 2017; 168: 584-599.
- Flaherty KT, Le DT, Lemery S. Tissue-Agnostic Drug Development. Am Soc Clin Oncol Educ Book 2017; 38: 222-230.
- Offin M, Liu D, Drilon A. Tumor-Agnostic Drug Development. J Clin Oncol 2018; 286-295.
- Remon J, Dienstmann R. Precision oncology: separating the wheat from the chaff. ESMO Open 2018; 3: e000446.
- Latham A, Srinivasan P, Kemel Y et al. Microsatellite Instability Is Associated With the Presence of Lynch Syndrome Pan-Cancer. J Clin Oncol 2018; JCO1800283.