“DRIVER” GENE BASED TARGETED CANCER TREATMENT STRATEGIES IN THE POST CANCER GENOMICS ERA

In 2013, 10 years after the completion of the human genome, the cancer genome project has identified almost all possible cancer genes, which can be responsible for the malignant transformation and progression. These genes are called “driver” genes, and the pathogenic mutations to be “driver” mutations. The census of “driver genes” in 2013 counted 138 genes and 1,5 million mutations. The situation is further complicated by the fact that up to 8 “driver” gene can be activated simultaneously in the same tumor. 2013 was a turning point also because several targeted therapies were registered. Currently there are about 30 targeted therapies in clinical use and more than 200 targeted compounds in clinical development. This means that in 3–4 years the number of drugs will at least double. Most of the current patients can only access these compound in clinical trials. But, patient already benefit significantly more even from phase I clinical trials, if they are selected based on the molecular profile of the tumor. Fortunately, the advancements of next generation sequencing technologies provide the opportunity to identify all “driver” gene – the whole molecular profile – in the patient’s tumor for the cost of one month targeted therapy. But the information generated can be only used in clinical practice if the results are processed by “molecular info-bionics”.