"Cancer is fundamentally a disease of altered genomics – genetic material making up the structure of cells. Because these alterations are different in each person, every tumour is programmed differently with genes made up of varying sequences of DNA.
This is why not everyone will respond the same way to a given treatment. Determining the DNA sequence that makes up the genome of each tumour (genomic sequencing) helps doctors understand how the tumour may be effectively targeted."
Those of us that have taken interest in learning about our specific form of CLL will be well aware of the benefit of having a FISH test prior to starting treatment and have some appreciation for why patients can respond quite differently to CLL treatment. Some of us can achieve a complete remission after very few FCR cycles for instance, whereas others only gain a partial remission after completing the full course. Some of us sadly have to cease treatment due to debilitating side effects.
While not specifically about CLL, this article does provide a high level overview of why Personalised/Precision Medicine holds so much promise and how it is already changing how we classify cancers. Elizabeth Williams, Associate Professor, School of Biomedical Sciences, Queensland University of Technology and Rik Thompson, Professor of Breast Cancer Research, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology explain:
Increased cost is the major disadvantage of Personalised Medicine, but as the article concludes:
"...there are advantages to the personalised approach that transcend cost.
Besides the potential of finding the right treatment, it can lead to stopping a therapy that isn’t working. Or result in a therapy not being undertaken at all; therapies that in many cases are themselves expensive and often have the added burden of side effects."