Médecine génomique en oncologie : état de l’art et défis à relever

Abstract

The utilization of genomic data to direct treatment for cancer patients represents the central principle of genomic medicine in oncology / onco-hematology, in which a patient is matched to a specific drug or therapy based on the genetic drivers detected in his or her tumor rather than the tumor's histologic classification. This rationalized approach is designed to allow increased response rates, more durable and deeper responses and decreased numbers of therapy-related side effects. In this review, we will discuss different facets of utilizing genomic data to direct cancer patient treatment from the general principles point of view and it's organization in France. We discuss the enlarging of actionable genomic alterations, and evolving strategies such as maintenance therapy that are driving the development of novel molecular diagnostic assays for patient follow up and guiding re-introduction of targeted therapies to prevent relapse. Finally we present an overview of the growing number of genomics-driven clinical trials and conclude with a discussion of future challenges in the implementation of molecular medicine for precision oncology.