Abstract
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 molecular
targets.
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, of cancer.
- 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 realized.
- Provides an overview of the early success stories of patient-selected
targeted therapeutics and highlights promising targeted therapeutics in
development.
- 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.
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