Transforming Cancer Prevention through Precision Medicine and Immune-oncology

Abstract

We have entered a transformative period in the history of cancer prevention. Recent remarkable advances in sequencing technology and computational biology have now provided us with unprecedented opportunities to study the biology of premalignancy, including deep genomic characterization of these lesions, and a detailed assessment of the tumor immune microenvironment. This extraordinary technology has enabled development of novel genomic biomarkers to personalize cancer detection, identified driver mutations in circulating DNA from patients with premalignant lesions, and defined immune gene signatures that are predictive of progression to invasive malignancy. More recently, we have witnessed the remarkable realization of the early promise of immunotherapy which has emanated from a deep understanding of the complexities of the immune system. Just as precision therapy and immunotherapy are transforming cancer treatment, precision medicine and immunoprevention approaches are being translated to the clinic and showing great promise. Here, we set out a brief agenda for the immediate future of cancer prevention, which will involve precision medicine and immunoprevention – pivotal elements of a broader domain of personalized public health.