Next-generation sequencing transforms today’s cancer research Next-generation sequencing (NGS) technologies can parallelize sequencing processes and produce millions of short-read sequences concurrently. The advent of NGS technologies has transformed today’s cancer genome research by providing an unbiased and comprehensive method of detecting somatic genome alterations [1]. The application of NGS technologies, through whole-genome, -exome and -transcriptome approaches has led to the discovery of mutated genes that drive oncogenic phenotypes in tumors. In a recent The Cancer Genome Atlas (TCGA) Pan-Cancer effort [2], 127 mutated driver genes were identified from 3281 tumors across 12 tumor types. These cancer drivers converged on several well-known pathways such as cell cycle and MAPK pathways. Interestingly, these drivers are also involved in cellular processes in cancers that have previously been less well characterized such as histone modification, RNA splicing, cellular metabolism and proteolysis. Mutations in transcription factors are more tissue specific, whereas mutations in histone modifiers are shared among multiple cancer types. The average number of driver mutations varies across tumor types and most individual tumors have two to six mutations [2]. Generally, larger numbers of driver mutations are involved in tumors with high levels of background mutations [3]. For example, most squamous cell lung carcinomas are attributed to life-long tobacco exposure. Carcinogens from tobacco exposure can cause a broad spectrum of DNA lesions on the genome, and this increases the chance that mutations conferring a small growth advantage to cells are selected in the lung microenvironment. Many such mutations with small effects can accumulate in a specific group of cells over time and collectively lead to carcinogenesis. This is in contrast to hematologic cancers, where fewer driver mutations (with potentially large effects) are observed in tumors with low background mutations. Driver genes are promising drug targets and their discovery has the potential to revolutionize personalized gene-targeted treatments that guide patient therapy according to the genomic profile of the tumor. The battle of Dr Lukas Wartman at Washington University in St Louis (WUSTL; MO, USA) against leukemia is a prime example of the promise of personalized medicine [4]. When Wartman had relapsed a second time, his colleagues at WUSTL sequenced the entire genome of DNA and RNA from his cancerous cells. His RNA sequencing showed that a gene called FLT3 was unexpectedly overproduced by his cancer cells. It so happens that the drug Sutent, previously approved for treating advanced kidney cancer, effectively inhibits FLT3. Sutent was prescribed to Wartman, and his leukemia was in remission 2 weeks later. In next decade, we will witness many such cases come to the forefront of cancer treatment and soon realize the promise of personalized medicines purred by advances in cancer genomics and associated drug development. part of Editorial
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