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Slow and Steady

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A study published in NEJM last week underscored how much researchers still have to learn about the structure and genomics of tumors. The study showed that even a single tumor is more heterogeneically complex than previously thought and can carry multiple mutations. Experts said the findings suggested that personalized oncological care would hard to achieve. The study also suggested that standard methods of tumor assessment, like single needle biopsy, give an incomplete picture of a patient's tumor as they sample from only one site and may miss mutations at other sites.

But hard doesn't have to mean impossible, says Amy Abernethy at the Personalized Medicine Coalition's The Age of Personalized Medicine blog. "For the sake of simplicity, we want to think of personalized cancer care as a lock and key; each tumor has a specific puzzle interface, and when the puzzle piece is identified then the cancer melts," Abernethy says.

The NEJM article shows there is a "need for many keys to a myriad of locks, each tailored for a particular tumor at a particular point in time," she says. This does not mean that personalized medicine is not achievable, she adds. While single needle biopsies of tumors may not provide a complete picture, they are a good starting point for treatment. And the genomic and genetic analyses being conducted on tumors by many researchers are a good step on the path towards full scientific understanding of cancer and how to treat it.

"The underlying message here is that although we have made great progress, we are still early in our journey," Abernethy says. "As we uncover new and unimagined pathways during the scientific discovery process, we should not be deterred or disheartened. We just aren't there yet."

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