Organ-agnostic precision oncology

When we think of cancer, we mainly use the organs from which it originated as designation and therapy is for the most part specific to this tissue type. That said, each cancer can be unique, and the molecular pattern of the malignant cells can vastly differ between individuals. Currently though all patients with a similar cancer type undergo similar therapies. By utilising genomic, transcriptomic and in some cases epigenetic data, it is possible to tailor therapy options for the individual with these diagnostic tools. The basis of the analysis can be the tissue or even a liquid biopsy and ranges from qPCR of specific markers to next generation sequencing (NGS) of the whole exome (WES) or the complete transcriptome (RNA-Seq). For the interpretation, publicly available databases that link mutations and expression of target genes to active compounds are used. In addition, pathway and multivariant analysis to find likely connections that are to some degree associated with pharmacogenetic mode of action are interpolated. The combined findings can help to generate a personalised list of compounds that are potentially effective for the cancer at hand. Drug and therapeutic recommendations can be already approved for the specific disease based on tissue type, other malignancies, or have completely different indications altogether in an off-label use. To ensure safety, pharmacological interactions have to be checked in-silico for unproblematic combinational therapy. If the organ of origin gives the basic information, precision oncology employing sufficient data can widen the range of options in this dire disease.