Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO, USA.
Nat Cancer. 2021 Sep;2(9):879-890. doi: 10.1038/s43018-021-00250-4. Epub 2021 Sep 16.
Although all cancers share common hallmarks, we have long realized that there is no silver-bullet treatment for the disease. Many clinical oncologists specialize in a single cancer type, based predominantly on the tissue of origin. With advances brought by genetics and cancer genomic research, we now know that cancers are profoundly different, both in origins and in genetic alterations. At the same time, commonalities such as key driver mutations, altered pathways, mutational, immune and microbial signatures and other areas (many revealed by pan-cancer studies) point to the intriguing possibility of targeting common traits across diverse cancer types with the same therapeutic strategies. Studies designed to delineate differences and similarities across cancer types are thus critical in discerning the basic dynamics of oncogenesis, as well as informing diagnoses, prognoses and therapies. We anticipate growing emphases on the development and application of therapies targeting underlying commonalities of different cancer types, while tailoring to the unique tissue environment and intrinsic molecular fingerprints of each cancer type and subtype. Here we summarize the facets of pan-cancer research and how they are pushing progress toward personalized medicine.
虽然所有癌症都具有共同的特征，但我们早就意识到，针对这种疾病并没有“一刀切”的治疗方法。许多临床肿瘤学家主要根据肿瘤的起源组织专门研究单一类型的癌症。随着遗传学和癌症基因组研究的进展，我们现在知道，癌症在起源和基因改变方面存在着巨大的差异。与此同时，一些共同特征，如关键驱动突变、改变的途径、突变、免疫和微生物特征等领域（许多是通过泛癌症研究揭示的），提示了用相同的治疗策略针对不同癌症类型的共同特征进行靶向治疗的诱人可能性。因此，旨在阐明癌症类型之间差异和相似性的研究对于了解肿瘤发生的基本动力学以及为诊断、预后和治疗提供信息至关重要。我们预计，针对不同癌症类型的潜在共性的治疗方法的开发和应用将得到越来越多的重视，同时针对每种癌症类型和亚型的独特组织环境和内在分子特征进行调整。在这里，我们总结了泛癌症研究的各个方面，以及它们如何推动个性化医学的进展。
