Since many of those therapies are targeted, their adverse event profile is more tolerable because they are not killing rapidly dividing cells. The patients can tolerate it on an outpatient basis, making their quality of life much higher. In my opinion, that cancer is likely to become more of a chronic disease.
Some of the other things that I discussed are combinatorial therapy. I would not be administering that therapy as a pathologist, but as we understand these biomarkers, we will start to understand sequences of progression and how to control that cancer. We are learning as we go, but cancer will become a chronic disease.
Are there any unmet needs that should be addressed?
The largest unmet need is the need for education—not only for the oncologist, but even for my pathology colleagues and other healthcare providers. There are varying levels of implications to the tests, such as testing the tumor to determine whether it has a marker that can be hit. Sometimes some of the tests can also imply other things about the patient, such as if they have a hereditary predisposition.
There are multitudes to the technologies out there and, when you start combining those different technologies into one result, you have an exponential range of possibilities. The educational gap is the greatest unmet need.
ASCO updates guideline to include testing for new RAS mutations. American Society of Clinical Oncology. https://gicasym.org/asco-updates-guideline-include-testing-new-ras-mutations. Published January 15, 2016. Accessed December 12, 2017.