Understanding the molecular characteristics of a patient's cancer can increase the likelihood of selecting the treatment most likely to help. In some cases, there may be a "targeted therapy" option - a drug designed to more precisely target cancer cells while sparing healthy tissue.

• For an overview, see NCI's fact sheet, Targeted Cancer Therapies.  Also see a Targeted Therapies Tutorial for a visual guide to the topic.
• NCI's Experimental Therapeutics Program (NExT) aims to safely shorten the timeline for drug development and to boost the number of targeted therapies entering the clinical pipeline.
• Examples of specific advances in personalized cancer care:
• Some hospitals are already using genetic and molecular information from tumors to match patients with the most appropriate drugs in an affordable and timely manner. See the NCI Cancer Bulletin's Making Personalized Cancer Care Routine.
• NCI researcher Louis M. Staudt, M.D., Ph.D.,  has successfully used genomic technology to reliably distinguish Burkitt lymphoma from diffuse large B-cell lymphomas. Accurate diagnosis based on the molecular characteristics of the disease enables the selection of the best treatment. See the story in The Nation's Investment in Cancer Research. 
• As demonstrated through NCI-funded clinical trials, trastuzumab (Herceptin®) was one of the first targeted drugs to be found effective against a particular subtype of cancer - breast tumors that make too much of a protein called HER-2 (see NCI press release).
• NCI-supported researchers found that patients whose colorectal cancer tumors have a mutant form of the KRAS gene do not benefit from treatments involving cetuximab (Erbitux®), and can therefore be spared that drug's side effects and cost. See the NCI Cancer Bulletin's Colorectal Cancer Drugs Require Careful Patient Selection.

Personalized cancer care will rely on a foundation of knowledge from a wide range of scientific fields, as noted in a special issue of the NCI Cancer Bulletin. Among the initiatives now receiving NCI support:

Biospecimen Research

• Researchers studying the molecular basis of cancer need high-quality biospecimens (blood or tissue samples) that have been properly collected, stored, and managed, and that come from racially and genetically diverse sources. NCI's Office of Biorepositories and Biospecimen Research (OBBR) is leading a national initiative to establish best practices and speed their implementation. See a video and find other information on OBBR's Web site.

Genome Research

• A complete catalog of the human cancer genome has the potential to allow categorization of the mutations found in different tumors, ultimately providing insights into the causes of cancer and leading to new targets for drug development.
• The Cancer Genome Atlas (TCGA) initiative aims to identify and characterize the genetic changes associated with human cancer, starting with brain, lung, and ovarian cancers. These cancers were selected because of the availability of high-quality human tissue collections (biorepositories).
  
• The TARGET initiative parallels the goals of the TCGA, seeking to rapidly identify valid therapeutic targets in childhood cancers leading to more effective treatments.    

Proteomics Research

• Tumors shed proteins and other molecules (known as biomarkers) into blood, urine, and other easily accessible bodily fluids. These biomarkers may enable clinicians to better monitor the course of treatment and assess the patient's response.
• For an overview, see NCI's Fact Sheet Proteomics and Cancer.
• NCI's Clinical Proteomic Technologies for Cancer (CPTC) initiative supports this effort by the evaluation and development of standardized methodologies along with high-quality community reagents to measure these biomarkers. See a visual tutorial on proteomic technologies and cancer, part of CPTC's Patient Corner.

Integrating Biological and Clinical Data

• Personalized cancer care requires the collection, analysis, sharing, and integration of massive amounts of biological and clinical data. NCI's cancer Biomedical Informatics Grid (caBIG™) serves as the cornerstone of NCI's efforts to develop the technologies and systems that enable further discovery and knowledge sharing in the cancer community.

Nanotechnology Research

• Nanotechnology is the creation of useful materials, devices, and systems through the manipulation of matter on a vanishingly small scale. The NCI Alliance for Nanotechnology is coordinating global efforts to apply these technologies to the pursuit of personalized cancer care.  See a visual tutorial on nanodevices, part of our Understanding Cancer Series.