Is there enough benefit to justify sequencing all patients’ tumors? Yes.
A fundamental premise of oncology—indeed of all medicine—is that every disease, even an untreatable one, warrants a diagnosis. The light microscope, invented in the 1500s, is still used to diagnose cancer. Peering at the surface of cells to determine their tissue of origin renders a diagnosis. However, if we are to improve our ability to treat and defeat cancer, we must supplement this centuries-old technology with the “molecular microscope.” Genomic testing permits interrogation of the inside of the cell and definition of a tumor’s precise coding sequence. Genomics is the diagnosis, and the most powerful argument for its universal use is that every patient afflicted with cancer deserves a diagnosis.
Subbiah V, Kurzrock R. Universal Genomic Testing Needed to Win the War Against Cancer: Genomics IS the Diagnosis. JAMA Oncol. 2016;2(6):719–720. doi:10.1001/jamaoncol.2016.0078
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