What Are the Scientific and Clinical Gaps in Cancer Personalized Medicine?

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The era of personalized medicine has yet to be fully realized for patients with advanced cancer that are receiving chemotherapy. There are several fundamental scientific gaps in this area as highlighted in prior posts. The following gaps are:

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1. We do not know whether genomic biomarkers improve patient survival.
2. We do not know whether measuring drug susceptibility and drug resistance and application of that knowledge improves patient survival.
3. We do not know how to translate multiple genetic mutations in cancer into measured drug susceptibility and drug resistance and what dose of chemotherapy is sufficient.
4. We do not know whether measuring drug susceptibility and genomics in cancer stem cells will result in better outcome than measuring the same in daughter cells of these stem cells (progenitor cells).
5. We do not know whether the results of issues from items 1-4 obtained from patients treated in community hospitals (where drug resistance is likely lower) will be different than that measured in tertiary academic hospitals (where drug resistance is likely higher).

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For personalized medicine to be truly realized, these scientific experiments must be carried out.

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