Minimizing the toxicity and side effects of treatments while increasing their efficacy is the main goal of the new cancer therapies goal . To do so in a personalized way by seeking the most appropriate drugs for each patient is the main goal of the so-called "Precision Medicine". A modality in plenary session of the Executive Council boom that has starred in the I International Workshop on Genomic Testing in Cancer, held in Pamplona, in the research center Médica Aplicada, CIMA of the University of Navarra. The congress addressed the latest techniques for determining the genomic or molecular tumor profile of each patient, its main therapeutic targets and the latest drugs that allow personalized treatment.

This first international workshop -organized by the Clínica Universidad de Navarrathe MD Anderson Cancer Center in Houston and the University of Navarra CIMA of the University of Navarra - brought together the leading experts in this targeted medicine at quotation and was attended by nearly 200 specialists from all over the world. Among the most relevant speakers were scientists of the stature of Dr. Hilario E. Mata, director of the Global Academic Programs at MD Anderson Cancer Center Houston (Texas, USA), Dr. Ignacio Wistuba, molecular pathologist at the same center and co-director of this workshop together with Dr. Ignacio Gil Bazo, director of department of Oncology at Clínica Universidad de Navarra. The main opening discussion paper of the workshop was given by Dr. Rafael Rosell, one of the most prestigious and awarded clinical and molecular oncologists in the field of lung cancer. lecture Dr. Joaquim Bellmunt, director of the Dana-Farber Cancer Institute's Bladder Cancer Center and professor at Harvard University in Boston, Massachusetts (USA), also gave a keynote address.

Advances in personalized medicine

"Today, in oncology, in order to provide personalized, precision medicine, we need to be able to offer our patients a targeted treatment, based on a therapeutic target," warns Dr. Ignacio Gil Bazo. Hence the essentially internship vocation with which the symposium was born, "due to the oncologist's need to know the genomic diagnostic techniques, the possible detectable genetic alterations and the main drugs directed at a specific target of a tumor subject ", indicates the specialist.

Genetic targets and detection techniques

The term "target" is applied in medicine to a molecular alteration core topic, in this case, in the activation of tumors, and against which a particular treatment can be directed.

The main stumbling block that arises in this precision medicine, warns Dr. Gil Bazo, who has experience in this subject of personalized treatments, "is that the therapeutic targets must be detectable" and, therefore, it is necessary to be very familiar with the different technological options and the technical limitations that exist to study these key targets and their genes in their different manifestations. This aspect is core topic especially in a field like this, where technology is constantly evolving and it is necessary for the professional to keep up to date. A chapter to which the first workshop of the workshop was dedicated.

Oncologists, molecular pathologists, geneticists, biologists and basic researchers, among other specialties, "must know very well what they can expect from each technique, what their specific performance is" to see what they can offer each patient in each oncological pathology. With a single goal: "that a patient with a specific target, an altered gene that directs that tumor, receives a treatment against that specific gene". In this way, the specialist will avoid administering, by default, a conventional treatment, which is not very specific, such as conventional chemotherapy with a profile of sometimes very relevant toxicity and a leave or moderate efficacy, "in favor of a potentially very effective therapy that is not very toxic for that patient".

New treatments and ongoing research

A second section of the course was devoted to the different existing treatments applicable to the molecular profile of patients: drugs, some of them already third generation, that can act as targeted therapy against certain alterations. "It is necessary to know these new therapeutic options aimed at specific molecular profiles when the first line of treatment fails," emphasizes Dr. Gil Bazo. Basic concepts about the technology, "what can be expected from each specific technique, what should I ask for, how should I interpret it, what drugs are available and which ones will arrive soon", are issues that the oncologist should know in order to guide the treatment of his patients at clinical practice.

The third part of the workshop focused on showing the research and clinical trials in progress so that, if necessary, the patient could be referred to the medical center that is developing them. Also discussed was how to select patients for clinical trials by virtue of their genomic test. And linked to this aspect, the scientific meeting showed the important role of immunotherapy "as one of the great advances in the targeted treatment of cancer and its interweaving with genomic diagnosis," the specialist explained.

The last workshop developed the fourth section of congress dedicated to the future lines that are being drawn in this field, related to new technologies for tumor detection and molecular alterations involved in different types of cancer. Among the main procedures, the so-called "liquid biopsy" was discussed, a technique that makes it possible to monitor, in a very gentle way, the efficacy of targeted treatment for a specific patient, and which also provides information on the prognosis of the disease by means of a simple blood test, without having to retake a biopsy of the tumor tissue.