Cancer diagnosis and evaluation of treatment in the genomic era

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Published: 22 Dec 2015
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Prof Richard Schilsky - Chief Medical Officer, American Society for Clinical Oncology (ASCO), USA

Prof Schilsky describes his talk at the 3rd EurocanPlatform Translational Research Course on what we need to know to establish a diagnosis, to determine a prognosis and select the best treatment for cancer patients, and how the approach to all of these has altered during the genomic era.

He also considers what significance this area has for clinical practice, what the next steps are and what obstacles exist.

 

3rd EurocanPlatform Translational Research Course

Cancer diagnosis and evaluation of treatment in the genomic era

Prof Richard Schilsky - Chief Medical Officer, American Society for Clinical Oncology (ASCO), USA


My talk is one of the very first talks in the course so it’s a broad overview of what we need to know to establish a diagnosis, to determine the prognosis and to select the best treatment for cancer patients and how our approach to all of those areas has changed now in the genomic era where we’ve begun to use many more genomic and other kinds of biomarkers and particularly to refine prognosis and select therapy.

What significance does this have for clinical practice?

My talk in this course is sort of a context setting talk. The goal is to familiarise the students with the general way in which we approach the management of patients with cancer so that as they continue in their research they understand what are the unmet medical needs, how their research can help to fill the gaps in our knowledge and the ways in which we are beginning to introduce new technologies, genomics, proteomics and so on, into clinical medicine.

What are the next steps?

What I tried to illustrate in the talk is the fact that as we learn more and more about the underlying biology of cancer and as that knowledge leads us to well-validated clinical biomarkers that we’ve got to integrate that into our diagnosis and treatment planning.

Besides money, what obstacles have you faced?

In the broadest possible sense the greatest obstacle is just the enormous complexity of cancer. Every time we get a new insight, learn something more about cancer, we realise how much more complicated it is than what we thought. So money is certainly an obstacle, you can’t do research without money. Obtaining well-validated bio-specimens to study is an obstacle in many cases, having specimens that have good clinical annotations so that you can relate a biological finding to a clinical outcome, that’s an obstacle for many people. And another major challenge nowadays is building the necessary teams of scientists and clinicians to do this very complex and very integrative research that requires not only people of great depth of knowledge and of science but the scientific technologies, the clinical medicine, how these all have to come together to really lead to the next advances.