Introduction and overview of cancer precision medicine
While cancer causes premature death in millions of persons around the globe yearly, in the last few years incredible advances have been made in our understanding of molecular drivers of cancers. Cancer treatment programs have benefited significantly from the discovery of targeted drivers and synthetic lethal approaches leveraging existing and novel therapeutics. Much of this progress have reflected rapid advances in high throughput genomic sequencing technology that allow clinical implementation of assays that can rapidly interrogate tumors for the presence of any of 1000s of individual molecular alterations. While significant gains have been made in our understanding of the molecular basis of cancer (and multiple novel therapeutics have been established through this work), outcomes in many cancer subtypes continue to be unacceptably poor. Additionally, uptake of molecular testing and limited access to novel therapeutics in many areas has limited the ability of precision medicine to improve outcomes for cancer patients. In this chapter, we provide an overview of these issues as an introduction to the remainder of this volume.