Point: The Imprecise Pursuit of Precision Medicine: Are Biomarkers to Blame?

Author: Bishal Gyawali MD
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Bishal Gyawali, MD, is a medical oncologist with experience in cancer care in both low-income and high-income countries. After graduating from medical school in Nepal with 7 gold medals, he is currently in the final year of his postgraduate training and PhD in medical oncology at Nagoya University Graduate School of Medicine, Japan, as a MEXT scholar. Dr. Gyawali is a medical consultant at the not-for-profit Anticancer Fund, Belgium, and also holds a faculty affiliation at the Institute of Cancer Policy, London, United Kingdom. His original research and opinion articles have been published in top oncology journals. He also provides critical commentary on oncology updates every month at his blogs on the ecancer Web site (http://ecancer.org/). He is an editorial adviser to BMJ, and a Journal of Global Oncology Editorial Fellow for 2017. His areas of clinical and research interests include evidence-based oncology practice, global oncology, cancer policy, cancer management in resource-limited settings, financial toxicities of cancer treatment, clinical trial methods, and supportive treatments of cancer. Dr. Gyawali tweets at @oncology_bg.

The ideas and viewpoints expressed in this commentary are those of the author and do not necessarily represent any policy, position, or program of NCCN.

  • 1.

    West HJ. No solid evidence, only hollow argument for universal tumor sequencing: show me the data. JAMA Oncol 2016;2:717718.

  • 2.

    Prasad V. Perspective: the precision-oncology illusion. Nature 2016;537:S63.

  • 3.

    Barsanti-Innes B, Hey SP, Kimmelman J. The challenges of validating in precision medicine: the case of excision repair cross-complement group 1 diagnostic testing. Oncologist 2017;22:8996.

    • Search Google Scholar
    • Export Citation
  • 4.

    Lee SM, Falzon M, Blackhall F et al.. Randomized prospective biomarker trial of ERCC1 for comparing platinum and nonplatinum therapy in advanced non–small-cell lung cancer: ERCC1 Trial (ET). J Clin Oncol 2017;35:402411.

    • Search Google Scholar
    • Export Citation
  • 5.

    Niedernhofer LJ, Bhagwat N, Wood RD. ERCC1 and non-small-cell lung cancer. N Engl J Med 2007;356:25382540.

  • 6.

    Patel SP, Kurzrock R. PD-L1 expression as a predictive biomarker in cancer immunotherapy. Mol Cancer Ther 2015;14:847856.

  • 7.

    McLaughlin J, Han G, Schalper KA et al.. Quantitative assessment of the heterogeneity of PD-L1 expression in non-small-cell lung cancer. JAMA Oncol 2016;2:4654.

    • Search Google Scholar
    • Export Citation
  • 8.

    Tannock IF, Hickman JA. Limits to personalized cancer medicine. N Engl J Med 2016;375:12891294.

  • 9.

    Prasad V, Gale R. What precisely is precision oncology—and will it work? Available at: http://www.ascopost.com/issues/january-25-2017/what-precisely-is-precision-oncology-and-will-it-work/. Accessed January 25, 2017.

    • Search Google Scholar
    • Export Citation
  • 10.

    Massard C, Michiels S, Ferté C et al.. High-throughput genomics and clinical outcome in hard-to-treat advanced cancers: results of the MOSCATO 01 trial. Cancer Discov 2017;7:586595.

    • Search Google Scholar
    • Export Citation
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