Genomics is just the beginning of a new wave of cancer research, said a panel at the World Science Festival held in New York City in June. The Cancer Genome Atlas has moved past its pilot phase and into full gear to sequence a few thousand samples of various types of cancer, all to better understand how cancer arises. "It's still way below what we ought to do," said the Broad Institute's Eric Lander, "but why not knock it off in the next five years?"
But knowing what genes are mutated in certain cancers is only part of the battle. "The beauty of finding a gene is that is just the beginning," said the University of Chicago Medical Center's Olufunmilayo Olopade. The panelists speculated that in the future, cancers would be classified by their mutations, rather than by the affected organ or tissue — the University Washington's Mary-Claire King pointed out that BRCA mutations have been found to be involved in not only breast and ovarian cancer, but also prostate and pancreatic cancers. Then, drugs could be developed to treat those specific pathways and those specific mutations. King, though, noted that pharmaceutical companies tend to be wary of slicing up their markets, and may be loath to develop drugs for the small percentage of the population with a certain mutation. In addition, Lander said that cancers are ever evolving and can develop resistance to targeted drugs. He suggested that a cocktail of therapies could be used to treat cancer, as is done to treat HIV.
Genomics is starting to move into the clinic, though its progress can be frustrating. Physician and author of Emperor of All Maladies Siddhartha Mukherjee gave the example of a young woman with a lethal cancer who came to his clinic. After her exome was sequenced, and Mukherjee could tell her which genes were mutated in her cancer. "But I can't do a damn thing about it," he said.