Delivering precision medicine in oncology today and in future-the promise and challenges of personalised cancer medicine: a position paper by the European Society for Medical Oncology (ESMO)

Although the description and interpretation of cancer genetics has been at the core of cancer research for more than a century, in this decade genomic medicine is set to profoundly transform every aspect of cancer care. Already, the anecdotal cases of individuals who have not responded to conventional chemotherapy but for whom whole genome sequencing has identified a gene target for directed therapy with remarkable clinical effect [1], point to a time in the not-too-distant future when cancer genome sequencing will be a routine adjunct to the clinico-pathological 'work-up' of a newly diagnosed cancer. For now, the identification of genes central to cancer biology is generating highly relevant diagnostic, prognostic and therapeutic information that has already translated to the clinic. The extraordinary pace of change is set to continue. The new era of personalised cancer medicine will touch every aspect of cancer care-from patient counselling, to cancer diagnosis, tumour classification, treatment and outcome-that demands a new level of in-depth education and collaboration between researchers, cancer specialists, patients and other stakeholders. In this position paper, ESMO sets out the current status in the field of personalised cancer medicine and addresses issues and challenges for the medical oncology community.