Question ID: WS-125
Submitted by: Michael Lerman
March 17, 2012
Sequencing of natural human tumors is teaching us invaluable lessons. It is becoming clear that the new dogmas created in the post genome era are being questioned. The previously suspected genetic heterogeneity of tumors is now proven on the sequence level. The extreme genetic heterogeneity of individual tumors and the existence of multiple tumors (not metastases) pose fundamental doubt on the prevailing dogma of targeted drug(s) and personalized treatments. Besides, the analysis of tumor genomes by Bert Vogelstein (http://www.youtube.com/watch?v=KE8TY0gT--g) has shown that tumors have none, or one, or rarely two targets implying that the targeted drug(s) will not affect most of the heterogeneous CSC (cancer stem cels) residing in different locations within a given tumor. It follows that personalized treatment with targeted drugs will not as a rule halt cancer growth or cure cancer; this is the view of most clinicians facing daily the onslaught of cancer. The question is what should we now do to treat and cure cancers, should we continue looking for illusive tumor targets and targeted drugs (with off-target targets)? Michael Lerman, M.D., Ph.D.
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