Dr. Goel on the Evolution of Precision and Personalized Medicine in Cancer Care

Sanjay Goel, MD, MS, director of Phase I/Investigational Therapeutics, medical oncologist, professor of Medicine, Division of Medical Oncology, Section of Solid Tumor, Rutgers Robert Wood Johnson Medical School, discusses the evolution of precision and personalized medicine in cancer care.

Precision and personalized medicine share some similar characteristics, as both represent a medical model where a patient’s treatment is based on something specific that is found within their tumor, Goel says. However, there are some inherent differences between precision and personalized medicine. Precision medicine is more mathematically based compared with personalized medicine, whereas personalized medicine focuses on tailoring a particular therapy to a specific patient, Goel adds.

Ultimately, the terminology most commonly used regarding precision and personalized medicine is biomarkers, as both are consistently driven by the presence of these markers in the tumor of an individual patient, Goel continues. The use of genetic and molecular profiling in cancer care has defined precision medicine in the space, and the implementation of precision medicine has grown over the past two decades, Goel says.

The inception of precision medicine dates back approximately 20 years, Goel says. The Human Genome Project was completed in 2003, and in 2015, United States President Barack Obama announced the launch of the Precision Medicine Initiative.

The start of this initiative coincided with the initiation of the phase 2 NCI MATCH trial (NCT02465060), and this study utilized targeted therapy directed by genetic testing for the treatment of patients with advanced refractory solid tumors, lymphomas, or multiple myeloma. The study aimed to identify patients with genetic abnormalities, such as mutations, amplifications, or translocations, who might benefit more from treatment which targets their tumor's particular genetic abnormality.

In recent years, the oncology community has observed successes with the use of precision medicine, and one of the best examples is the use of a pembrolizumab (Keytruda) in patients who have microsatellite instability or a high tumor mutational burden, Goel concludes.