ABSTRACT
Personalized medicine is designed to create individualized therapy that fi ts an individuals’ cancer like a key fi ts a lock (see Chapter 16). Incremental benefi ts in combination with traditional chemotherapy have been seen in a number of malignancies, and transformational benefi ts in a handful of genetically simple, “oncogene-addicted” tumors that are highly dependent on a single signaling pathway with limited ability to adapt. Cures are still rare. The key-lock metaphor and underlying strategy refl ect assumptions that tumors are homogeneous and static, even though we know otherwise. Personalized medicine strategies will be even more benefi cial when they are augmented to incorporate the notions of tumor heterogeneity and the dynamic nature of tumors.
