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Role of genetic engineering for offering precision medicine in cancer treatment

Precision medicine in cancer treatment is important in preventing, treat or diagnose cancer by using the genetic information from the person’s own gene. Genetic Engineering plays an important role in precision medicine. Precision medicine uses targeted therapy. Cancer could be a major focus of the precision medicine initiative and developments in precise and effective treatments may benefit many other chronic diseases. Precision oncology or precision medicine in cancer treatment focuses on matching the most accurate and effective treatment to every individual cancer patient based on the genetic profile of cancer and the patient. Because each and every single cancer patient exhibits a special type of genetic profile. Also, this genetic profile can change over time due to mutation, more patients will benefit if therapeutic options are tailored thereto, individual. Therefore it avoids the concept of “one-size-fits-all” in terms of cancer treatment.

One of the foremost notable samples of precision medicine in cancer treatment is that the discovery of the BCR-ABL gene fusion in chronic myelocytic leukemia (CML). Unfolding the genetic profile of CML ends up in the discovery of a selective inhibitor of BCR-ABL, imatinib, which exhibited broader treatment coverage because, unlike other gene mutations, the BCR-ABL gene fusion occurs in the majority of CML patients. Another example includes the effectiveness of precision medicine in cancer treatment be like trastuzumab, lapatinib, pertuzumab, or ado-trastuzumab emtansine against human epidermal protein receptor 2 (HER2)-positive carcinoma in case of breast cancer.

The Molecular Analysis for Therapy Choice (NCI-MATCH) is the clinical trial of precision medicine-supported genetic features of patients which is devoid of traditional tumor histology. The Molecular Profiling-based Assignment of Cancer Therapy (NCI-MPACT) is another innovative trial in precision medicine in cancer treatment to check the hypothesis that targeting an oncogenic driver mutation is more efficacious than not targeting it. NCI-MPACT will recruit advanced cancer patients who are unresponsive to simple therapeutic options and possess mutations in one among three genetic pathways that include DNA repair, PI3-K/mTOR (phosphoinositide-3 kinase/mammalian target of rapamycin), and Ras/Raf/MEK (mitogen-activated protein kinase). The influence of the latest technologies like the CRISPR/Cas system and cryo-electron microscopy (cryo-EM) will broaden and sharpen our ability to spot novel therapeutic targets for precision oncology. CRISPR/Cas technology enables controlled exchange, insertion, and deletion of DNA sequences, unlike spontaneous mutation, and may easily generate animal models that mimic the mutation status of patients. Recently, a gene therapy trial to treat myeloma, melanoma, and sarcoma with CRISPR/Cas has been approved by the National Institute of Health which is waiting for approval from the FDA. Additionally to CRISPR/Cas, cryo-EM may be a promising tool for precision oncology. All these are possible due to Genetic engineering. Without genetic engineer, these would never be possible.

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