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The realization that cancer is ultimately a disease of mutated genes has driven cancer researchers to ask how this information can be used to direct specific treatments to individual patients. This query represents one of the newest and most important trends in oncology, personalized medicine. Its core insight is that a physician could improve the treatment of a disease by understanding its molecular biology through well-timed tests of the highest quality and relevance.
Medicine has made progress in tailoring treatments for cancers through molecular analysis. But in practice, patients and physicians often have only limited access to that information and so do not benefit from advancing scientific knowledge. The company N-of-One was founded to overcome the barriers to access for this valuable data and to help individuals navigate the challenging road to optimal cancer treatment. The time is right for this approach, because as Mara Aspinall, chief executive officer of On-Q-ity and director of the Personalized Medicine Coalition, explains, “personalized cancer diagnostics are accelerating in all areas from drug choice to drug dosing to efficacy monitoring.”
Recently, projects such as the Cancer Genome Atlas have documented thousands of mutations in cancer cells that can lead to unregulated cell growth and prevent apoptosis (cell death), the hallmarks of malignancy. Each individual’s cancer seems to have its own collection of such abnormalities. Those mutant genes, and not the organ in which a tumor arises, are ultimately what treatments need to target.
“When I started, we would diagnose cancer based on tissue morphology,” explains Paul Mischel, a pathologist and cell biologist at the University of California in Los Angeles. “That’s no longer sufficient.” Instead, scientists are increasingly looking at molecular profiles to see which “biological switches” are turned on or off. Finding the key rel- evant switches in a particular tumor is not always easy, however, because different switches may be activating the same metabolic pathways. Mapping out the possibilities is a research priority in oncology.
The amount of genetic data available, since the dawn of the biotechnology era, has vastly expanded from just 606 base pairs and 680,338 sequences in 1982. The biggest challenge for health technologies will be to process and make sense of the ever-growing banks of information.
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