Abstract
Translational oncology represents a bridge between basic research and clinical practice in cancer medicine. Today, translational research in oncology benefits from an abundance of knowledge resulting from genome-scale studies regarding the molecular pathways involved in tumorigenesis. In this Forum article, we highlight the state of the art of translational oncology in five major cancer types. We illustrate the use of molecular profiling to subtype colorectal cancer for both diagnosis and treatment, and summarize the results of a nationwide screening program for ovarian cancer based on detection of a tumor biomarker in serum. Additionally, we discuss how circulating tumor DNA can be assayed to safely monitor breast cancer over the course of treatment, and report on how therapy with immune checkpoint inhibitors is proving effective in advanced lung cancer. Finally, we summarize efforts to use molecular profiling of prostate cancer biopsy specimens to support treatment decisions. Despite encouraging early successes, we cannot disregard the complex genetics of individual susceptibility to cancer nor the enormous complexity of the somatic changes observed in tumors, which urge particular attention to the development of personalized therapies.
Highlights
Mulshine and colleagues discussed how epithelial cancers could be blocked in the early stages of tumorigenesis if agents were developed to interfere with growth factors or other molecules involved in tumor promotion: ‘Through this type of translational research, important applications of molecular biology may greatly improve the success of preventative strategies for cancer control’ [3]
This detailed translational research will inform breast cancer prognosis within the 10 groups, and the underlying biology of these novel stratifications of breast cancer. This will allow the potential to utilize these to predict response to novel targeted small molecule therapies, and an increasing number of novel immune therapies through both antibody and vaccine treatments. These novel stratified groups have been defined from the start with access to the clinical follow-up data and, inevitably, the advances achieved will have important impact and treatment outcomes on patients with breast cancer
Gefitinib and afatinib were designed against wild-type epidermal growth factor receptor (EGFR), osimertinib was designed to be selective for mutant EGFR, thereby increasing the precision of our therapies [46]. The approval of this drug demonstrates that targeting resistance mechanisms is a successful paradigm for ongoing research to improve outcomes in lung cancer patients with mutant EGFR and other known oncogenes, such as the ALK and ROS1 genes
Summary
Longitudinal United Kingdom screening program for ovarian cancer (OvCa) involving serum measurements of a tumor biomarker, namely carbohydrate antigen 125; the cost-effectiveness of this program is yet to be defined, the program created a biobank that will support translational research from the clinic back to the laboratory. Report recent advances in lung cancer research, focusing on oncogene-driven targeted therapy and immune checkpoint inhibitors that have changed the survival expectations for patients with advanced disease.
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