Abstract
In their Sounding Board article on personalized medicine, Tannock and Hickman (Sept. 29 issue) make constructive contributions toward a possible midcourse correction. Precision medicine is based on targeting a validated and genetically stable driver of disease.
To date, proof-of-concept trials have not supported this premise. The precision approach has worked in bacterial infections and in certain hematologic cancers that are characterized by clonal proliferation.
However, solid cancer is different; local invasion and metastasis are more relevant than clonal proliferation and are dependent on multiple coordinated and sequential mechanisms.