Clinical Chemistry
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Clinical Chemistry 55: 684-697, 2009. First published February 26, 2009; 10.1373/clinchem.2008.118554
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(Clinical Chemistry. 2009;55:684-697.)
© 2009 American Association for Clinical Chemistry, Inc.

Reviews

Utilizing the Molecular Gateway: The Path to Personalized Cancer Management

Jonathan B. Overdevest1, Dan Theodorescu1 and Jae K. Lee2,a

Departments of1 Molecular Physiology and Biological Physics; and 2 Public Health Sciences, University of Virginia Health Sciences Center, Charlottesville, VA.

aAddress correspondence to this author at: Department of Public Health Sciences, Box 800717, University of Virginia Health Sciences Center, Charlottesville, VA 22908, USA. E-mail jaeklee{at}virginia.edu.

Background: Personalized medicine is the provision of focused prevention, detection, prognostic, and therapeutic efforts according to an individual’s genetic composition. The actualization of personalized medicine will require combining a patient’s conventional clinical data with bioinformatics-based molecular-assessment profiles. This synergistic approach offers tangible benefits, such as heightened specificity in the molecular classification of cancer subtypes, improved prognostic accuracy, targeted development of new therapies, novel applications for old therapies, and tailored selection and delivery of chemotherapeutics.

Content: Our ability to personalize cancer management is rapidly expanding through biotechnological advances in the postgenomic era. The platforms of genomics, proteomics, single-nucleotide polymorphism profiling and haplotype mapping, high-throughput genomic sequencing, and pharmacogenomics constitute the mechanisms for the molecular assessment of a patient’s tumor. The complementary data derived during these assessments is processed through bioinformatics analysis to offer unique insights for linking expression profiles to disease detection, tumor response to chemotherapy, and patient survival. Together, these approaches permit improved physician capacity to assess risk, target therapies, and tailor a chemotherapeutic treatment course.

Summary: Personalized medicine is poised for rapid growth as the insights provided by new bioinformatics models are integrated with current procedures for assessing and treating cancer patients. Integration of these biological platforms will require refinement of tissue-processing and analysis techniques, particularly in clinical pathology, to overcome obstacles in customizing our ability to treat cancer.






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Copyright © 2009 by the American Association for Clinical Chemistry.