Top Line: “Is genome-guided cancer treatment hyped?”
The Study: That was the subject of intense debate at the AACR annual meeting between David Hyman and Vinay Prasad. Let’s face it, there is a growing over-use of gene sequencing and early stage clinical trials to attract patients to cancer centers as customers. Sure it sounds great to identify and target some individual genetic tumor mutation, but what are the chances that will actually happen? According to a new report, those chances are south of 5% with even lower chances of achieving any meaningful response. In light of this, it can be alarming how quickly oncologists will consider wavering from standard treatments in favor of a precision medicine approach. At the heart of this issue is the popular notion (best described by Malcolm Gladwell) that cancer is a puzzle. Simply put, puzzles are a lack of information. Just find that one missing piece and...voila! Mysteries, on the other hand, are complex problems laced with uncertainty even in the setting of an overabundance of information. 
Bottom Line: Our current one gene, one drug approach is hyped. Because there is a lot more to solving the mystery of cancer than it’s genome. | Marquart, JAMA Oncol 2018


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