Precision cancer medicine: Concepts, current practice, and future developments

Author:

Edsjö Anders123,Holmquist Louise13,Geoerger Birgit45,Nowak Frédérique6,Gomon Georgy78,Alix‐Panabières Catherine910,Staaf Johan11,Ploeger Carolin1213,Lassen Ulrik14,Le Tourneau Christophe151617,Lehtiö Janne18,Ott Patrick A.19,von Deimling Andreas2021,Fröhling Stefan2223,Voest Emile724,Klauschen Frederick2526272829,Dienstmann Rodrigo30,Alshibany Aisha31,Siu Lillian L.31,Stenzinger Albrecht1213ORCID

Affiliation:

1. Department of Clinical Genetics Pathology and Molecular Diagnostics, Office for Medical Services, Region Skåne Lund Sweden

2. Division of Pathology Department of Clinical Sciences Lund University Lund Sweden

3. Genomic Medicine Sweden (GMS) Kristianstad Sweden

4. Department of Pediatric and Adolescent Oncology Gustave Roussy Cancer Campus Université Paris‐Saclay Villejuif France

5. INSERM U1015 Gustave Roussy Cancer Campus Université Paris‐Saclay Villejuif France

6. Health Technologies Institute Inserm Paris France

7. Department of Molecular Oncology and Immunology The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital Amsterdam The Netherlands

8. Department of Medical Oncology Leiden University Medical Centre Leiden The Netherlands

9. Laboratory of Rare Human Circulating Cells University Medical Center of Montpellier Montpellier France

10. CREEC, MIVEGEC University of Montpellier Montpellier France

11. Division of Translational Cancer Research Department of Laboratory Medicine Lund University Lund Sweden

12. Institute of Pathology University Hospital Heidelberg Heidelberg Germany

13. Centers for Personalized Medicine (ZPM) Heidelberg Germany

14. Department of Oncology Copenhagen University Hospital Copenhagen Denmark

15. Department of Drug Development and Innovation (D3i) Institut Curie Paris France

16. INSERM U900 Research Unit Saint‐Cloud France

17. Faculty of Medicine Paris‐Saclay University Paris France

18. Department of Oncology Pathology Karolinska Institutet Science for Life Laboratory Stockholm Sweden

19. Department of Medical Oncology Dana‐Farber Cancer Institute and Harvard Medical School Boston Massachusetts USA

20. Clinical Cooperation Unit Neuropathology German Cancer Research Center (DKFZ) Heidelberg Germany

21. Department of Neuropathology Institute of Pathology Heidelberg University Hospital Heidelberg Germany

22. Division of Translational Medical Oncology National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ) Heidelberg Germany

23. German Cancer Consortium (DKTK) Heidelberg Germany

24. Oncode Institute The Netherlands Cancer Institute Amsterdam The Netherlands

25. Institute of Pathology Charite – Universitätsmedizin Berlin Berlin Germany

26. German Cancer Consortium (DKTK) Partner Site Berlin, and German Cancer Research Center (DKFZ) Heidelberg Germany

27. BIFOLD – Berlin Institute for the Foundations of Learning and Data Berlin Germany

28. Institute of Pathology Ludwig‐Maximilians‐University Munich Germany

29. German Cancer Consortium (DKTK) German Cancer Research Center (DKFZ), Munich Partner Site Heidelberg Germany

30. Oncoclínicas Precision Medicine Oncoclínicas Group Sao Paulo Brazil

31. Princess Margaret Cancer Centre Toronto Ontario Canada

Abstract

AbstractPrecision cancer medicine is a multidisciplinary team effort that requires involvement and commitment of many stakeholders including the society at large. Building on the success of significant advances in precision therapy for oncological patients over the last two decades, future developments will be significantly shaped by improvements in scalable molecular diagnostics in which increasingly complex multilayered datasets require transformation into clinically useful information guiding patient management at fast turnaround times. Adaptive profiling strategies involving tissue‐ and liquid‐based testing that account for the immense plasticity of cancer during the patient's journey and also include early detection approaches are already finding their way into clinical routine and will become paramount. A second major driver is the development of smart clinical trials and trial concepts which, complemented by real‐world evidence, rapidly broaden the spectrum of therapeutic options. Tight coordination with regulatory agencies and health technology assessment bodies is crucial in this context. Multicentric networks operating nationally and internationally are key in implementing precision oncology in clinical practice and support developing and improving the ecosystem and framework needed to turn invocation into benefits for patients. The review provides an overview of the diagnostic tools, innovative clinical studies, and collaborative efforts needed to realize precision cancer medicine.

Publisher

Wiley

Subject

Internal Medicine

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