Precision Medicine Approaches in Hypoxic Cancers

Tumor hypoxia is a significant non-measurable factor that predicts cancer treatment outcomes. Radiation, chemotherapy, and surgery are not effective against hypoxic tumors, as they stimulate cell proliferation, invasion, resistance to cytotoxic-factor attacks, and promote metastatic activity. Level 1 evidence supports the efficacy of therapies targeting normalizing hypoxia or reversing treatment resistance caused by hypoxia. However, there is currently no reliable method for measuring tumor oxygenation. Precision medicine is now within reach due to a paradigm change that emphasizes the unique molecular changes of the tumor. The rising number of basket trials that choose specific molecular targets is indicative of this trend. However, there are flaws, such as the difficulty in identifying the driver due to the intricacy of cancer cells with concurrent molecular changes and tumor heterogeneity, potentially contributing to targeted agents’ ineffectiveness. Translational research has been a game-changer in cancer care, shifting from organ-based treatment strategies to individualized, deep molecular analysis. Technologies like RNA sequencing and next-generation sequencing have enhanced the ability to identify predictive or prognostic molecular changes. Treatment decisions will soon be based on the molecular abnormality profile or “signature” of the tumor, rather than the tumor's tissue type or anatomical site of origin. This will greatly improve patient prognosis and quality of life. The purpose of this study is to examine the current state and potential future developments of personalized medicine in cancer care.