Advances in genomics have brought convenience of genetically stratified cancer patients which would affect the tailored therapy. Additionally, genomics in the combination of molecular biology, engineering, and bioinformatics has revolutionized understanding of predisposed genes inducing the occurrence of cancer development , as well as of potential treatment responses.
Genomics has remarkably influenced cancer research. Investigating the molecular characteristics in terms of gene expression, structural shifts of the genome , and mutations, as well as their influence in metastatic behavior and therapeutic responses will revolutionize cancer treatment.
Key characteristics of individual cancers are hoped to be identified and then support to establish tailored therapeutics. Thus investigators have been attempting to find out sets of genes associated with cancer and novel drug development targets. For instance, Roche’s antibody MPDL3280A (RG7446) in clinical development acts against an immune checkpoint blockade expressed in tumors.
Cancer Diagnostics for treatment
Genetic tests have already changed medical practice. Patient’s genetic information obtained from genetic tests is often employed for differentiating their vital genotypes, and physicians thereby offer optimal medical decisions, practices and drugs. Decipher Prostate Cancer Classifier from GenomeDx, analyzing the activity of 22 genetic markers expressed in the prostate cancer, classifies the patient’s tumor independently of Prostate-Specific Antigen (PSA) rise. Scientists developed genome-wide search algorithms of more than a million markers, and discovered these 22 markers related to aggressive disease.
Myriad’s Prolaris is a risk-stratification tool for patients with prostate cancer. Designed to measure the aggressiveness of a patient’s cancers to better predict an individual’s relative risk of disease progression within ten years, it can enable physicians to better define a treatment/monitoring strategy for their patients.
Oncogenic mutations of driver Genes
Adding to the complexity of data is the discovery of “driver” genes and their role in cancer biology. Elli Papaemmunuil and colleague recently described their analysis of oncogenic mutations in large, well-characterized patient cohorts of myelodysplastic syndromes (MDS), characterized by dysplasia, ineffective hematopoiesis, and a variable risk of progression to acute myeloid leukemia.
Using previously identified mutations in genes implicated in RNA splicing, DNA modification, chromatin regulation, and cell signaling, the investigators sequenced 111 genes across 738 patients with MDS or closely related neoplasms to explore the role of acquired mutations in MDS biology and clinical phenotype.
The scientists reported that 78% of patients had one or more oncogenic mutations and that they could identify complex patterns of pairwise association between genes, indicative of epistatic interactions involving components of the spliceosome machinery and epigenetic modifiers.
References:
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2. Genetic testing comes of age in prostate cancer. Trends in Urology & Men’s Health.2014;5( 2): 9–13,
3. Academic medical centers: ripe for rapid-learning personalized health care. Sci Transl Med. 2011 Sep 21;3(101):101cm27.