The Problems, Premise, and Promise of Personalized Oncology

In the “Emperor of all Maladies” Mukherjee eloquently summarizes the utter complexity of this mélange of diseases described spuriously under the single label of “cancer.” Modern biology reveals that biological and patient heterogeneity, with all that implies, summarize the challenges facing both patients and their care givers. The heterogeneity is at times almost stultifying in degree and complexity, making it seemingly impossible to conjure even precise diagnosis let alone truly effective disease prediction, prevention, or personalized therapy, or to effect accurate individualized prognosis. But there is promise for meeting the challenges that are inherent in the high density, multidimensional biologic data (genomic, epigenetic, metabolic and proteomic) now realizable, provided we have the smarts to design the computational tools necessary to tease out the underlying both normal biology and mechanisms of disease.”