JCO: Special Series Overview - Precision Oncology

open access

"In this Special Series issue, Journal of Clinical Oncology presents a
systematic assessment of cancer genomic information and its accelerating clinical impact. In the scientific literature and lay press, the
relevant discipline is often called personalized, or precision, cancer
medicine. The word personalized conveys the sense that cancer
genomic data may facilitate rational treatment choices that are tailored
to individual patients. The term precision refers to prospects for enhanced molecular resolution, mechanistic clarity, and therapeutic cogency that may accompany clinical implementation of genomics
technologies. Wehave chosen the term genomics-driven cancer medicine
in recognition of the fact that knowledge that emanates specifically
from the cancer genome will likely continue to direct the opening
act of precision oncology as it plays out in clinical and translational
studies over the next several years......

The issue concludes with a perspective by Mendelsohn,13 who
chronicles the transformation in cancer care over the last 40 years
through the lens of genetics and molecularly targeted therapies. Its
overarching theme, borrowed from a Tahitian painting by Gauguin,
surveys the past, present,andfuture of the genomics-driven paradigm.
Together with the other articles in this Special Series issue, this perspective blends the promise of precision cancer medicine with a sobering reminder of the many obstacles that must be circumvented even to render a thorough test of its inherent hypotheses. Despite the hype, one presently cannot assert with confidence that genomics-driven
medicine will win the day across all cancers. Nonetheless, the confluence
of science, technology, and drug discovery has produced a tractable
investigative path with a reasonable chance to improve the
outcomes of many patients with cancer. From the perspective of
patients and their oncologists who struggle daily with advanced cancer,
the genomics-driven framework seems to echo the Ce´sar Vallejo
poem,14  the content of which speaks of suffering, but the title of which
reads: “I am going to speak of hope.”"