Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1484, Houston, TX 77030, USA.
Nat Rev Clin Oncol. 2012 Sep;9(9):542-8. doi: 10.1038/nrclinonc.2012.127. Epub 2012 Jul 31.
Personalized cancer therapy is based on the precept that detailed molecular characterization of the patient's tumour and its microenvironment will enable tailored therapies to improve outcomes and decrease toxicity. The goal of personalized therapy is to target aberrations that drive tumour growth and survival, by administering the right drug combination for the right person. This is becoming increasingly achievable with advances in high-throughput technologies to characterize tumours and the expanding repertoire of molecularly targeted therapies. However, there are numerous challenges that need to be surpassed before delivering on the promise of personalized cancer therapy. These include tumour heterogeneity and molecular evolution, costs and potential morbidity of biopsies, lack of effective drugs against most genomic aberrations, technical limitations of molecular tests, and reimbursement and regulatory hurdles. Critically, the 'hype' surrounding personalized cancer therapy must be tempered with realistic expectations, which, today, encompass increased survival times for only a portion of patients.
个体化癌症治疗的基础是，对患者肿瘤及其微环境进行详细的分子特征分析，从而能够制定出针对性的治疗方案，改善疗效并降低毒性。个体化治疗的目标是通过为合适的患者施用合适的药物组合，靶向驱动肿瘤生长和存活的异常。随着高通量技术在肿瘤特征分析以及分子靶向治疗方案的扩展方面取得进展，这一目标正变得越来越可行。然而，在实现个体化癌症治疗的承诺之前，还有许多挑战需要克服。这些挑战包括肿瘤异质性和分子进化、活检的成本和潜在发病率、针对大多数基因组异常的有效药物的缺乏、分子检测的技术限制以及报销和监管障碍。关键的是，围绕个体化癌症治疗的“炒作”必须与现实的期望相协调，目前，个体化癌症治疗仅能延长一部分患者的生存时间。
