Drug Discovery Today  Volume 18, Numbers 15/16  August 2013 EDITORIAL editorial Charlotte R. Lemech Hendrik-Tobias Arkenau The future is here: tumour profiling in day-to-day clinical practice The aspiration for personalised medicine in cancer care is felt on both sides – by oncologists aiming to optimise the treatments they deliver and by patients trying to receive the best treatment avail- able. At the basis of personalised medicine is the understanding of genetic alterations of an individual’s tumour and delivering the best sequence or combinations of treatment to address this. There has been an exponential rise in the knowledge of tumour biology and driving factors on tumorigenesis that is changing the treat- ment landscape for many cancers, while DNA sequencing tech- nologies now generate large data-sets of information far more quickly and cheaply than traditional first-generation Sanger sequencing. Classification of an individual’s tumour based on its genetic profile combined with novel technologies to guide treatment decisions and predict response, rather than using a one-size-fits- all approach, can be used to tailor better one’s treatment pathway and improve efficacy with reduced toxicity. Such a classification would assess the molecular signature of a patient’s tumour, often a complex array of mutations, some of which may be drivers of tumorigenesis, and others that are considered passenger muta- tions, as they do not significantly alter cancer progression. Whole genome sequencing (WGS) has formed the backbone for sequen- cing the cancer genome and identifying key molecular aberra- tions, from first-generation Sanger sequencing to next-generation sequencing (NGS) platforms and beyond. Although decreasing, the time and costs associated with WGS are significant and current alternatives for more rapid results that can provide clinical gui- dance include exome sequencing and cancer genotyping. Interpretation of this increasingly complex wealth of genomic information requires equally complex and well-supported bioin- formatics systems to optimise data storage and interpretation. Moreover, as early integration of these technologies and of mole- cular profiling into early phase clinical trials and biomarker devel- opment is becoming increasingly common, appropriate validation to ensure the quality of results and subsequent treatment is essential. As the availability and general use of NGS expands, it is parti- cularly important to maintain accessibility across the wider com- munity. With this purpose in mind, Sarah Cannon Research UK (SCR-UK), in association with University College London- Advanced Diagnostics (UCL-AD), uses innovative technology including NGS to characterise an extensive panel of actionable and exploratory mutations and assist in clinical and research decisions. In 2013, the SCR-UK/UCL-AD London-based facility will have the ability to conduct NGS of more than 35 cancer- specific genes for personalised medicine applications, commen- cing with an 11 gene clinically focused panel and expanding 1359-6446/06/$ - see front matter ß 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.drudis.2013.06.006 www.drugdiscoverytoday.com 689