K.K. Jain, Textbook of Personalized Medicine, DOI 10.1007/978-1-4939-2553-7_10, 199
© Springer Science+Business Media New York 2015
Chapter 10
Personalized Therapy of Cancer
Introduction
Management of cancer has been unsatisfactory in the past but an understanding of
the molecular, genetic and genomic aspects of cancer is accelerating progress in
cancer therapy (Jain 2014 ). Several comprehensive studies have demonstrated the
utility of gene expression profi les for the classifi cation of tumors into clinically
relevant subtypes and the prediction of clinical outcomes. Role of oncoproteomics
in personalized management of cancer was fi rst emphasized in 2004 (Jain 2004 ).
Considerable progress has been made in this fi eld during the past few years. Other
factors that drive the development of personalized therapy for cancer are listed in
Table 10.1. The preceding chapter described how cancer cell therapy and cancer
vaccines can be personalized. Information presented in this section will show per-
sonalization of other cancer therapies.
Challenges of Cancer Classifi cation
Cancer is a very heterogeneous disease. Current classifi cations of cancer are based
on the type of tissue of origin, histological appearance and tendency to metastasize.
These provide only a limited view of cancer. It is now known that cancer varies both
genetically and phenotypically between patients who may have the identical type
and stage of cancer. Each person’s cancer is as unique as his or her fi ngerprint. This
variability helps to explain unpredictable responses to existing drug therapies that
have been observed to date. Large-scale expression monitoring on microarrays has
provided the ability to look at cancer at a molecular level and transcription of mRNA
messages from genes − transcriptional profi ling.
Tumor heterogeneity is underestimated as it is not heterogeneity between tumors,
but heterogeneity within an individual tumor as well, which has been mapped out