In many of our genome-obsessed minds, the problem of cancer had become reduced to a rather simple, scalable algorithm: find the mutations in a patient, and match those mutations with a medicine. All the other variables — the cellular environment within which the cancer cell was inescapably lodged, the metabolic and hormonal milieu that surrounded the cancer or, for that matter, the human body that was wrapped around it — might as well have been irrelevant blobs receding in the distance.
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Mutations within a cancer cell certainly carry information about its physiology — its propensity for growth, its vulnerabilities, its potential to cause lethal disease — but there’s a world of information beyond mutations.
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What if the “really clinically useful information” lies within these domains — in the networks of normal genes co-opted by cancer cells, in the mechanisms by which they engage with their host’s immune system or in the metabolic inputs that a cell needs to integrate in order to grow?
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The point is that precision medicine is not just precision mutant-hunting.
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[T]he reinvention of cancer therapy needs time, patience and diligence — and, yes, skepticism. By narrowing our definition of precision medicine too much, we almost narrowed our ambition to deliver precise, thoughtful therapy — or, at times, no therapy — to our patients. It would be a shame to view cancer through such narrow lenses again.Read full, original post: The Search for Cancer Treatment Beyond Mutant-Hunting
