Finding The Target

The era of precision medicine is firmly upon us. With the rise of genetic testing and genomic sequencing, one-size-fits-all chemotherapy treatments have given way to targeted therapies, allowing oncologists to tailor treatment regimens to the mutational status of individual patients.

But questions do remain: Who gets tested? Who pays? What are the barriers to implementing regular genomic sequencing for all patients?

In this issue of ONCOLOGY®, we spoke with Tanios S. Bekaii-Saab, MD, of the Mayo Clinic in Phoenix, Arizona, about the importance of genomic sequencing and the need to make genetic testing universal in gastrointestinal (GI) cancers.

“I think every single patient with a GI malignancy…has the right [to be sequenced], and we have to find every way possible to get them sequenced,” says Bekaii-Saab. “I need to understand what the rare mutational status of each patient is.”

Bekaii-Saab also discusses the rapid improvements in treatment for GI cancers, specifically colorectal cancer, that come from the ability to identify the proper target and proper treatment for each patient. “We’re catching up, and we’re catching up quickly,” Bekaii-Saab says of the use of biologic and immune-based therapies in the field of GI cancer. “And I think in the next 3 to 5 years, we’ll probably be ahead of the curve again.”

The need for regular testing and sequencing applies to all tumor types, and in this issue, you will also hear from Mark G. Kris, MD, of Memorial Sloan Kettering Cancer Center in New York, New York, on the avalanche of recent FDA approvals of lung cancer treatments—each made possible by the rise of targeted therapies.

Also in this issue, you will read a review of predictive biomarkers for immunotherapy response. With the meteoric rise of immune therapeutics for patients with cancer, the ability to predict and understand responses to these treatments has become essential.

For this month’s clinical quandary, you will read about the challenges of treating a patient with advanced prostate cancer during the coronavirus disease 2019 pandemic. How have treatment protocols changed? What can we do to ensure the best possible treatment with the lowest possible risk? Read on to find out.

Within these pages, you will also read a review of the optimal treatment duration of trastuzumab (Herceptin) for patients with breast cancer and a case study of a 33-year-old woman given a diagnosis of a locally advanced GI stromal tumor, and the impact her treatment has had regarding her fertility and potential for bearing children.

I hope you find our journal helpful in caring for your patients through what is likely one of the most challenging times in their lives. As always, thank you for reading.