Not yet is genomic medicine totally precise

collective sharing of findings and experiences among institutions will help improve the precision of precision medicine.

This is a great overview as to where we stand with molecular targeted agents. We increasingly understand that the drugs are not “precisely” targeted. We have learned that targeted agents have multiple sites of action and unanticipated side effects. New generations of drugs, such as the new series of PI3K and EGFR inhibitors, reduce side effects and narrow their spectrum of action. In addition, the multiplicity of mutations in a single tumor and clonal evolution of tumors at different metastatic sites lead to further imprecision in treatment planning. Analysis of circulating tumor cells and cell-free, circulating DNA may provide a more complete picture than a single biopsy.

Read more: http://theoncologist.alphamedpress.org/content/21/9/1029.full