Precision oncology

In 2018 the motto of the annual conference of the American Society of Clinical Oncology (ASCO) was the “expanding the reach of precision medicine” to more cancer patients. The cancer genome research of the past decades has identifi ed several targets for drug discovery, and by now a large wave of new targeted and immune therapies have reached the clinical practice. While previously only 10-20 new cancer drugs were registered in a decade, between 2010 and 2015 47 novel targeted were approved and there are around 2000 compounds in clinical development. Therefore, we can expect 100 new drugs by 2020 in this decade. There are new generation drugs for previous targets, which overcome drug resistance due to secondary mutations in the same target and now we often have sequential or combination therapies for resistance related to “pathway switch” caused by secondary mutations in other driver genes. The real challange today is, how to use precision medicine as method, to choose the treatment based on the pathomechanism of the tumor in the individual patient similarly to the infectious diseases.