oa Investigating the evolution and future impact of cancer treatment methods from one-size-fits-all to personalized approach

Cancer therapeutics have developed and improved overtime. Currently, the most common oncology therapeutics are chemotherapy and radiation therapy. These cancer therapies predominantly follow a 'one-size-fits-all' strategy. They attach general features common to all cancers, although the dose size and frequency are typically customized from one patient to another. Two popular forms of cancer therapeutics are chemo and radiation. These forms use different approaches. Chemotherapy attacks fast-dividing cells in the patient body. Since chemotherapy does not distinguish between good and bad cells, it can induce side effects. Side effects include hair loss, bone marrow problems, and digestive system problems. Chemotherapy kills hair follicles, blood cells in bone marrow, and intestinal cells in digestive system. High doses are required for chemotherapy to be effective. Moreover, not all types of cancer respond well to chemotherapy. Cancer cells are "smart" in the sense that they can eventually "learn" and detect chemotherapy and "adapt/protect" themselves, rendering chemotherapy impotent. Radiation therapy attempts to avoid chemotherapy shortfalls by damaging cancer cell DNA in the targeted body part. Radiation offers two main advantages over chemotherapy: (1) the former is targeted, so it does not damage other body parts, and (2) it is more effective because the DNA of the cancer cells are damaged beyond repair leaving no chance for adaptation. Radiation effectively causes the tumor to shrink and die. However, good cells can still be affected by radiation, and side effects can still occur, e.g. fatigue, memory loss, skin irritation, scar tissue, and chronic bowel effects. More recently, newer cancer therapies (known as targeted therapies) attack specific features or mutations found in individual cancers in an attempt to kill fast-dividing cells without killing normal healthy cells. A targeted therapy attacks specific mutated proteins or DNA known as biomarkers, found in individual types of cancer. Targeted therapy works only on the targeted biomarkers. Only patients with the correct DNA mutation (biomarker) can benefit from targeted therapies. Targeted therapies have some advantages over chemo and radiation therapies. They operate in a wider "effective treatment window" and cause fewer side effects (joint and muscle pain, fatigue, skin lesions, diarrhea, and nausea) compared to either chemo or radiation. The paper offers a historic perspective of the evolution of the personalized cancer treatment approach, it enablers, current research issues and its future promise.