4.7 Review

Tumor Evolution as a Therapeutic Target

期刊

CANCER DISCOVERY
卷 7, 期 8, 页码 805-817

出版社

AMER ASSOC CANCER RESEARCH
DOI: 10.1158/2159-8290.CD-17-0343

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资金

  1. European Community's Seventh Framework Programme [602901 MErCuRIC]
  2. H2020 grant [635342-2 MoTriColor]
  3. IMI [115749 CANCER-ID]
  4. AIRC Special Program Molecular Clinical Oncology 5 per mille [9970]
  5. Fondazione Piemontese per la Ricerca sul Cancro-ONLUS 5 per mille Ministero della Salute
  6. AIRC IG [16788]
  7. Fondazione Umberto Veronesi
  8. Cancer Research UK [FC001169]
  9. UK Medical Research Council [FC001169, MR/FC001169/1]
  10. Wellcome Trust [FC001169]
  11. Cancer Research UK (TRACERx and CRUK Cancer Immunotherapy Catalyst Network)
  12. CRUK Lung Cancer Centre of Excellence
  13. EIF Stand Up To Cancer (SU2C)
  14. Rosetrees Trust
  15. NovoNordisk Foundation [16584]
  16. Prostate Cancer Foundation
  17. Breast Cancer Research Foundation (BCRF)
  18. European Research Council (THESEUS)
  19. Marie Curie Network PloidyNet
  20. National Institute for Health Research
  21. University College London Hospitals Biomedical Research Centre
  22. Cancer Research UK University College London Experimental Cancer Medicine Centre

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Recent technological advances in the field of molecular diagnostics (including blood-based tumor genotyping) allow the measurement of clonal evolution in patients with cancer, thus adding a new dimension to precision medicine: time. The translation of this new knowledge into clinical benefit implies rethinking therapeutic strategies. In essence, it means considering as a target not only individual oncogenes but also the evolving nature of human tumors. Here, we analyze the limitations of targeted therapies and propose approaches for treatment within an evolutionary framework. Significance: Precision cancer medicine relies on the possibility to match, in daily medical practice, detailed genomic profiles of a patient's disease with a portfolio of drugs targeted against tumor-specific alterations. Clinical blockade of oncogenes is effective but only transiently; an approach to monitor clonal evolution in patients and develop therapies that also evolve over time may result in improved therapeutic control and survival outcomes.

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