Decision making in precision oncology: an issue of mutational contextuality

[摘要] Cancer being a genomic disease evolves over time and following drug treatment by successive acquisition of mutations in “driver” and/or “passenger” genes. Thus the uncovering of mutations in cancer cells unlocks the option(s) for targeted treatment for patients for which they would have been unqualified otherwise. The precision oncology which presents expanded treatment options to oncologists and patients fundamentally interrogates alterations of genes in terms of DNA, RNA, proteins and phospho-proteins in an individual patient’s tumor and harness these genomic and proteomic alterations in the background of tumor cell signaling. Thus a decision making in precision oncology wherein a drug or a combination of drugs is matched with an individual patient’s tumor not only considers the mutation of a gene but also the site of the mutation [1,2] to know the functionality of the mutation along with the accompanying mutations in different genes in the same tumor, Mutational Contextuality.

[学科分类] 肿瘤学