Precision Medicine in Oncology

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Andrew Pecora, MD, FACP, CPE, recently visited Evidence-Based OncologyTM to discuss the progress of COTA’s, a company created in 2011 to develop technology that Pecora said is poised to transform cancer care delivery by helping oncologists and other specialists make decisions that will yield the best outcomes in the most cost-effective way, all at the point of care.

Jeff Sharman, MD, medical oncologist, Willamette Valley Cancer Institute and Research Center; medical director, The US Oncology Network, explains how personalized medicine has changed the way physicians think about treatment for patients with chronic lymphocytic leukemia (CLL).

There has been dramatic growth in the number of labels relevant to precision medicine, but there remains a gap in the number available and what health plans actually cover, explained Kibum Kim, PhD, MSc, research assistant professor, University of Utah.

We need to bring together our real-world data and our reimbursement systems to recognize the fact that a lot of what could be gained by precision medicine is going to be based on a lot of research, explained Peter Paul Yu, MD, FASCO, FACP, physician-in-chief, Hartford HealthCare Cancer Center.

There are small subgroups within each tumor type and within each molecular type, and someday, we might be able to actually pair the 2 to give patients a little bit more personalization and precision to their treatments, said Victoria Villaflor, MD, associate professor of Medicine, hematology and oncology.

During this year's American Society of Clinical Oncology (ASCO) annual meeting, we sat down with 4 physicians to discuss their experiences with precision medicine, how it's changing oncology care, challenges associated with the shift, and where they think the future of precision medicine is headed.

After a decade of analyzing over 11,000 tumors from 33 types of cancer, the collaboration between the National Cancer Institute and National Human Genome Research Institute has launched the Pan-Cancer Atlas, providing a comprehensive understanding of 3 focus areas: cell-of-origin patterns, oncogenic processes, and signaling pathways.

Recent study results showed larotrectinib was effective in patients with tropomyosin receptor kinase fusion-positive cancer, regardless of the age of the patient or the tumor type. In addition to implications for the treatment of genetic alterations across tumor types, these study results underscore the importance of molecular profiling of tumors, through which patients were identified for the studies, on ensuring precision medicine is used in practice while simultaneously providing a cost-effective tool.

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