Oncogenomics: The Future
of Cancer Care analyzes the key advances and
challenges associated with translating research efforts into
successful, clinically meaningful therapeutic products. The
emergence of oncogenomics promises a new era of cancer care.
Over the next decade or so, biomedical researchers hope to have
fully catalogued all genetic alterations associated with cancer,
greatly expanding the number of “druggable” anticancer
Oncogenomics has already seen clinical and market success with
a handful of “first-generation” oncogenomic therapeutics
such as Herceptin, raising hope and expectations that safer and
more effective patient-selected targeted therapeutics will revolutionize
cancer therapy and transform cancer into a manageable chronic
disease. While patient-selected genomic-based therapy has only
recently emerged as a viable clinical practice, many experts
argue that it will become crucial not just in clinical practice
but as an integral component of targeted drug development.
However, despite the early success stories of Herceptin and
Gleevec, many leaders in the field are cautious about the extent
to which genomics will truly impact cancer care over the next
10 to 15 years. Employing the right tools, technologies, and
strategies will be crucial to realizing the clinical and marketplace
opportunities stemming from the burgeoning growth of oncogenomics.
Oncogenomics: The Future of Cancer
Care offers insightful evaluation
of the following key challenges to achieving this goal and examines
current approaches to addressing these issues:
• Preclinical drug candidate screening needs to be more predictive
in order to increase the chance that a targeted drug entering clinical
trials will succeed.
• Patient selection needs to be integrated into targeted drug
development and clinical practice.
• Many pharmaceutical companies remain resistant to the patient-selected
targeted drug model.
• Not all of the targets yielded by the Human Genome Project
are “druggable” and it is extremely difficult to determine
which genes associated with cancer are consequences, not causes,
• Most tumors involve multiple mutations, which could translate
into multiple pathways.
This report also:
• Evaluates important questions about the potential medical
and revenue benefits of targeted cancer drugs that are not being
• Provides an overview of the early success stories of patient-selected
targeted therapeutics and highlights promising targeted therapeutics
• Explores the scientific arguments for patient-selected clinical
development, discusses the disincentives and challenges to patient-selected
therapy, and examines the economics of patient-selected trials.
• Highlights key technologies used to discover cancer-associated
genetic variation and gene expression patterns, and discusses the
way in which the tools and technologies advanced by the HGP have
improved this discovery process. Some of the key in vitro and animal
model technologies being used to functionally test and “validate” (i.e.,
preclinically) these discoveries are summarized.
About the Author
Leslie A. Pray, Ph.D., is a geneticist, writer, and independent
consultant. She prepares policy reports for the Board on Global
Health at the National Academy of Sciences and has written extensively
on a range of genetic, biotechnology, infectious disease, biomedical,
and public health issues for The Scientist, Genomics and Proteomics,
Orion, the American Chemical Society, the American Association
for the Advancement of Science, Oak Ridge National Laboratory,
and the CBR Institute for Biomedical Research, among others.
Dr. Pray received her Ph.D. in population genetics from the University
of Vermont and her B.A. degree from the University of California,
Berkeley. She has been the recipient of numerous scientific research
awards, including an American Society of Naturalists Young Investigator
Award. Dr. Pray can be reached at firstname.lastname@example.org.