2.2.4　Monitoring Tumor Recurrence

Genomic analysis has established that numerous, variable mutations exert a compound effect to initiate disease onset and progression.Patients with the same cancer type and stage can respond differently to therapy and exhibit variable rates of disease progression based on the pathophysiological alterations underlying the carcinogenesis.For example, gene expression is assessed in breast cancer patients to guide medical decisions regarding treatment.On the one hand,Patients with estrogen or progesterone receptor positive breast cancer benefit from hormone therapy and those with HER2 positive breast cancer receive HER2 targeted treatments.On the other hand, these therapies are not effective in patients with TNBC, who are likely to benefit from adjuvant chemotherapy.Currently Precision Medicine is primarily utilized in guiding treatment decisions, but nonetheless, it is impacting health-care costs by optimizing therapies, reducing complications, and improving patient outcomes.(https://www.daowen.com)

Multi-omics initiatives aim to characterize the complex pathophysiology of oncogenesis in an effort to identify risk factors and diagnostic cancer biomarkers.As more patient specimens undergo multi-omics analysis, additional low frequency driver mutations and protein abnormalities will be identified as contributing to oncogenesis.The corresponding increase in the characterization of oncogenic proteogenomic profiles will in turn contribute to the evolution and expansion of Precision Medicine, which eventually will enable risk assessment in phenotypically healthy individuals, leading to an early diagnosis [4, 30].