In recent years, medicine has made significant progress in the fight against cancer. Many forms of cancer are now treated as chronic diseases offering quality years of life for the patient. Modern research has proven that there is no such thing as a “lung cancer” or a “breast cancer”. Even cancers classified histologically in the same category, such as adenocarcinoma or squamous cell carcinoma, can present different characteristics from patient to patient. Each tumor has its own “signature”, making treatment unique to each patient. It is typical that there can be cancers from the same organ (eg breast cancer) that differ so much from each other, as well as cancers from different organs that have common biological characteristics.

Biomarkers are critical to understanding cancer. When we refer to them, we are talking about specific genetic mutations that may be present in the tumor’s DNA. These mutations determine the sensitivity of the tumor to specific drugs. That is, through biomarkers we can understand which treatments will be more effective for the specific type of cancer in each individual patient.

The concept of personalized therapy is simple and at the same time revolutionary: we detect the unique biological characteristics of the tumor in each patient and provide a treatment that is “personalized” just like a key that opens a lock. This process involves several steps.

First, we detect the cancer through imaging tests, which show us the location and stage of the disease. The biopsy then allows us to take material from the tumor. With this material, we perform the morphological diagnosis, understanding exactly what type of cancer we are dealing with. The next step is to send the material for further genetic analysis.

An important tool in this process is next generation sequencing (NGS). This modern method of DNA analysis allows the simultaneous examination of many mutations. This is of particular importance, especially in the case of metastatic cancer, where the material available for biopsy may be limited. Through NGS we can examine hundreds of genes at once, gathering information that is essential for treatment.

This method enables us to detect which of the many mutations may be biomarkers and thus determine the appropriate treatment. For example, a drug approved for breast cancer with a particular mutation may also benefit patients with prostate or ovarian cancer if they carry the same mutation. A prime example is the BRCA1 and BRCA2 genes, known for their association with breast cancer. Initially, treatments targeting these mutations were only intended for women with breast cancer. However, clinical trials have revealed that these treatments are also effective in ovarian, prostate and pancreatic cancer patients who carry the same mutations. This availability of drugs in different types of cancer highlights the need for genetic analysis of tumors, regardless of the type of cancer they have.

The personalized approach is changing the way we understand and treat cancer. Based on biomarkers, we can subcategorize cancers based on their molecular profile, providing more targeted treatments that ensure greater efficacy and reduced side effects. This new era in oncology signals a hopeful outlook for patients as new methods and treatments are constantly being discovered and tested.

The global oncology community establishes the “tissue is the issue” guideline, i.e. the tissue sample from the tumor is the most catalytic issue. Because our goal is clear: personalization of treatment with the aim of both treating the disease and optimizing the quality of life of each individual patient.