Personalised Cancer Medicine: An ESMO Guide for Patients
Personalised cancer management – which means giving patients the optimum treatment according to their circumstances (including their genetics) and the molecular characteristics of their tumors – is a crucial theme of ESMO in 2013
What Is the Aim of Personalised Cancer Medicine
The aim of personalised Cancer medicine is clearly to make therapy more efficient for patients. A very small step in the process is to identify for every patient the main molecular driver of their tumor. We must understand that patients differ from each other, although they may have the same cancer type; for example, every patient with breast or bowel cancer will have a unique tumor. This is entirely new knowledge, so what we are trying to do now in the medical community is to identify each patient their type of disease and then give the drug that will work best.
Recent Approach to Cancer
Until recently, researchers and clinicians thought that all cancers deriving from the same site were biologically similar, and they classified the disease based on cell type (as determined by microscope assessment), size and presence/absence of regional nodes or distant metastases, as well as other features that may be observed on the tumor sample. Surgery has been, and still is, the cornerstone of treatment for most cancer patients, together with chemotherapy and radiation therapy. These treatments may have drawbacks and side effects, particularly chemotherapy and radiotherapy, which, by killing cells that divide rapidly, kill cancer cells but also heavily affect healthy cells, resulting in partial efficacy and unwanted side effects.
(1) Chemotherapy
The mechanism underlying chemotherapy is killing cells that divide rapidly by cancer medicine. Chemotherapy works throughout the whole body, while surgery and radiation therapy (acting as local treatments) have an effect on cancer cells in specific areas of the body.
(2) Radiation therapy
Radiation is energy that is carried by waves or a stream of particles. Radiation therapy works by damaging the genes (DNA) in cells. Genes control how cells grow and divide. When radiation damages a cancer cell’s genes, the tumor cannot grow and divide anymore. Radiation therapy kills cancer cells that are dividing but also affects the dividing cells of normal, healthy tissues.
3) Cancer Drugs Targeted Therapy
Cancer Drugs specifically acting against molecular targets in cancer cells – called targeted therapies – have been developed and are used to counteract some types of cancer in selected patients. However, many targets still need to be discovered, and many cancer drugs must be developed or improved.
New Evidence in Cancer Biology
Cancers originating from the same organ can vary significantly, although traditional diagnostic parameters remain important..In recent years, our understanding of tumor biology has improved dramatically. One step forward is represented by the possibility of classifying cancers based on critical molecular targets identified by the high-quality translational research of the last decades.
What Needs to be Done From Now On
Ongoing research is essential to gather comprehensive data on each tumor, identify all relevant targets, and determine the most effective treatment for each patient. This includes treatments aimed at curing cancer, slowing its progression, or alleviating symptoms.
What Cancer Patients Should be Aware of
Important information about the patient’s disease can be identified by tissue and blood sampling. This means obtaining one or more samples from the patient’s tissues and tumors. Patients should be aware that personalised cancer medicine is based on testing in molecular diagnostic laboratories, and therefore, it might not be available in all medical centres.
Optimal personalized care is based on a trusting relationship between the patient, the physician, and the multidisciplinary team. A holistic approach should consider not only the tumour’s biological characteristics but also the patient’s physiological and psychological status over their lifetime.
Challenges include ensuring that all patients have access to effective and affordable targeted therapies and raising awareness among the medical community and patients. A Need for Education and Research It is only through targeted education and continuous advancement in research that the goal of personalised medicine to provide the “right treatment to the right patient at the right time” will be achieved.
