4.8 Article

Functional precision oncology: Testing tumors with drugs to identify vulnerabilities and novel combinations

Journal

CANCER CELL
Volume 40, Issue 1, Pages 26-35

Publisher

CELL PRESS
DOI: 10.1016/j.ccell.2021.12.004

Keywords

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Funding

  1. National Cancer Institute (NCI) [R35CA242427]
  2. NCI grant [U54CA224076]

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Functional precision medicine is a strategy that provides personalized treatment guidance based on the immediate response of live tumor cells. The heterogeneity of human cancer requires personalized approaches for improved treatment outcomes. Traditional precision oncology relies on static tumor features, but only a small proportion of individuals benefit from this approach. Functional precision medicine can provide additional information on tumor vulnerabilities.
Functional precision medicine is a strategy whereby live tumor cells from affected individuals are directly perturbed with drugs to provide immediately translatable, personalized information to guide therapy. The heterogeneity of human cancer has led to the realization that personalized approaches are needed to improve treatment outcomes. Precision oncology has traditionally used static features of the tumor to dictate which therapies should be used. Static features can include expression of key targets or genomic analysis of mutations to identify therapeutically targetable drivers.Although a surprisingly small proportion of individuals derive clinical benefit from the static approach, functional precision medicine can provide additional information regarding tumor vulnerabilities. We discuss emerging technologies for functional precision medicine as well as limitations and challenges in using these assays in the clinical trials that will be necessary to determine whether functional precision medicine can improve outcomes and eventually become a standard tool in clinical oncology.

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