The Evolution and Clinical Impact of Diagnostic Testing - Episode 6

The Value of Personalized Medicine

Personalized medicine is definitely important in oncology, especially as we better understand the heterogeneity of various tumor types, said Edmund Pezalla, MD, MPH, when asked about the advantages of using personalized medicine in cancer care.

Pezalla explained that tumors are characterized more by their molecular profile than the pathology. “The other important thing is that tumors change over time and following treatment. So being able to find the new markers or other things that have changed within that tumor can impact decisions on second and third-line therapy,” he added. “There is no longer a one-size-fits-all in oncology and in many different areas.”

Pezalla indicated that there are a lot of unmet needs in oncology that can be listed by tumor type. Using pancreatic cancer and prostate cancer as examples, he said, “We have to understand that with diseases such as pancreatic cancer, there are some patients who survive much longer than expected—clearly they have a different tumor. There is also something different about prostate cancer that [develops] in someone who’s 50 years old versus someone who’s 80 years old.”

In his opinion, we need a much better understanding of the various tumor types and techniques to enable us to deal with these patients. “Even without personalized medicine, genomics, or biomarkers, we would still have a burgeoning number of treatments and we wouldn’t know which one can be used for a particular patient,” Pezalla said. He thinks that while the physician would base his decision on the epidemiology or demographic of the patient, what we really need is information on the genetic characteristics of the individual and their tumor.