Some good description of cancer, tumors, mutations and evolution, and then I think an overly optimistic view of personalized medicine – both in the comprehension and treatment sides (see Is personalized medicine a myth?, Who Will Lead Us As We Embrace Personalized Medicine And Cancer Care And Turn The Tide Against Cancer?). Quote:
Enter Personalized Medicine. Human ingenuity to the rescue. The solution goes like this. First, we are developing ways to find out what the combination of gene mutations is in every tumor. We call this discipline Molecular Diagnostics. Second, we are developing a collection of “smart” drugs that specifically inhibit each oncogene or activate each tumor suppressor gene, perhaps as few as a few hundred drugs in all. We call these Biologically Targeted Therapies. Molecular Diagnostics can then be used to interrogate the tumor about what its combination of mutations is. We can take this list to the kitchen full of ingredients, and return to the patient with the right cocktail of Biologically Targeted Therapies, one that will lock the tumor into an evolutionary dead end and send it to extinction.
The vision of Personalized Medicine fuels me and many other cancer researchers. This paradigm organizes our efforts, funnels our energies and keeps us motivated to tackle the most difficult scientific challenge of our age. There are weak spots in this paradigm, but it currently looks like the best shot we’ve got. We are not there yet, but much progress is being made for specific cancer types. It will take a lot more effort and money to see this vision realized. We cancer researchers will put in the effort — let’s hope that government and society will come up with the money.
In order to succeed we will also have to radically change the way we practice medicine. Matching macroscopic symptoms with standardized drugs just won’t do. Each cancer patient is a new scientific problem.