个性化医疗
精密医学
医学
肿瘤异质性
抗药性
癌症
液体活检
癌症医学
遗传异质性
生物信息学
生物标志物
计算生物学
癌症研究
肿瘤科
内科学
表型
病理
基因
生物
遗传学
作者
Geert A. Cirkel,Christa G Gadellaa-van Hooijdonk,Marco J. Koudijs,Stefan M. Willems,Emile E. Voest
出处
期刊:Future Oncology
[Future Medicine]
日期:2014-02-01
卷期号:10 (3): 417-428
被引量:26
摘要
Tumor heterogeneity is regarded as a major obstacle to successful personalized cancer medicine. The lack of reliable response assays reflective of in vivo tumor heterogeneity and associated resistance mechanisms hampers identification of reliable biomarkers. By contrast, oncogene addiction and paracrine signaling enable systemic responses despite tumor heterogeneity. This strengthens researchers in their efforts towards personalized cancer medicine. Given the fact that tumor heterogeneity is an integral part of cancer evolution, diagnostic tools need to be developed in order to better understand the dynamics within a tumor. Ultra-deep sequencing may reveal future resistant clones within a (liquid) tumor biopsy. On-treatment biopsies may provide insight into intrinsic or acquired drug resistance. Subsequently, upfront combinatorial treatment or sequential therapy strategies may forestall drug resistance and improve patient outcome. Finally, innovative response assays, such as organoid cultures or patient-derived tumor xenografts, provide an extra dimension to correlate molecular profiles with drug efficacy and control cancer growth.
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