Molecular diagnostics tailoring personalized cancer therapy - an oncologist’s view

Sep 24, 2026

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Medical oncology is rapidly evolving through personalized, targeted therapies enabled by advances in molecular diagnostics and deeper understanding of cancer pathophysiology. Specific genetic alterations are recognized as drivers, and drug development increasingly allows direct interference with corresponding pathways to tailor treatment to tumor molecular characterization. This precision oncology paradigm shift faces hurdles including clinical relevance assessment, managing intratumoral and time-dependent heterogeneity, and practical implementation in routine care. The review summarizes cancer-agnostic precision oncology, molecular tumor boards, limitations, and future prospects such as functional assessments and broader liquid biopsies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Introduction

The precision oncology paradigm

Molecular tumor boards

Limitations and future outlook

Virchows Archiv (2024) 484:169–179 [https://doi.org/10.1007/s00428-023-03702-7](https://doi.org/10.1007/s00428-023-03702-7) Molecular diagnostics tailoring personalized cancer therapy—anoncologist’s view Jakob M. Riedl1 · Florian Moik1 · Tamara Esterl1 · Sarah M. Kostmann1 · Armin Gerger1 · Philipp J. Jost1,2,3 Received: 8 July 2023 / Revised: 27 October 2023 / Accepted: 4 November 2023 / Published online: 20 November 2023 © The Author(s) 2023 Abstract Medical oncology is rapidly evolving with the implementation of personalized, targeted therapies. Advances in molecular diagnostics and the biologic understanding of cancer pathophysiology led to the identification of specific genetic alterations as drivers of cancer progression. Further, improvements in drug development enable the direct interference with these pathways, which allow tailoring personalized treatments based on a distinct molecular characterization of tumors. Thereby, we are currently experiencing a paradigm-shift in the treatment of cancers towards cancer-type agnostic, molecularly targeted, personalized therapies. However, this concept has several important hurdles and limitations to overcome to ultimately increase the proportion of patients benefitting from the precision oncology approach. These include the assessment of clinical relevancy of identified alterations, capturing and interpreting levels of heterogeneity based on intra-tumoral or time-dependent molecular evolution, and challenges in the practical implementation of precision oncology in routine clinical care. In the present review, we summarize the current state of cancer-agnostic precision oncology, discuss the concept of molecular tumor boards, and consider current limitations of personalized cancer therapy. Further, we provide an outlook towards potential future developments including the implementation of functionality assessments of identified genetic alterations and the broader use of liquid biopsies in order to obtain more comprehensive and longitudinal genetic information that might guide personalized cancer therapy in the future. Keywords Precision oncology · Molecular oncology · Targeted therapy · Personalized treatment · Cancer Introduction Precision oncology is currently revolutionizing the treatment of patients with cancer. Deciphering the underlying molecular alterations as drivers of cancer development and progression has led to an improved ability to understand and potentially interfere with pro-oncogenic pathophysiologic pathways [1 , 2] . This development has been enabled by several key factors . First, analyzing genetic information has technically evolved in the recent years via Jakob M. Riedl and Florian Moik contributed equally to this work. * Philipp J. Jost [philipp.jost@medunigraz.at](philipp.jost@medunigraz.at) 1 Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria 2 Medical Department III for Haematology and Oncology, School of Medicine, Technical University of Munich, Munich, Germany 3 BioTechMed-Graz, Graz, Austria methods of next-generation sequencing (NGS), enabling inexpensive and fast molecular diagnostics in routine clinical practice [1 , 3] . Further, decades of experimental research have led to the precise characterization of distinct oncogenic pathways including pro-oncogenic driver mutations, tumor-suppressive mechanisms, and components of the cancer-host interaction including mechanisms of impaired anti-cancer immunity [4] . Third, advancesin drug development have led to the ability to directly interfere with these distinct molecular pathways (e.g. , via tyrosine kinase inhibitors or monoclonal antibodies), which allows the development of personalized treatment approaches based on distinct patterns of genetic alterations [5] . In the present review, we aim to define the concept of personalized cancer therapy specifically in the context of molecular diagnostics, to discuss the application

FAQs

What is the core goal of precision oncology in this review?

To guide cancer prevention, diagnosis, and personalized treatment selection by using comprehensive molecular information at the individual patient level.

How do molecular diagnostics enable personalized cancer therapy?

Advances such as next-generation sequencing and improved drug development identify actionable genetic alterations and support targeted interference with specific oncogenic pathways.

What key challenges limit broader adoption of precision oncology?

Assessing the clinical relevance of identified alterations, capturing and interpreting molecular heterogeneity over time, and implementing precision oncology practically in routine clinical care.

Sep 24, 2026

Uploaded by awa