Cancer Precision Medicine, Personalized Medicine (herein, PMED) has been introduced to human cancer patients over the last 20 years and is now receding from the heightened promise at its introduction. There are lessons, including successes and failures from this human experience, that can be used to better deliver this future of cancer care to pet animals. Amongst the lessons is the intersection of the inclusion of genomics and other correlative endpoints into clinical trial, referred to as Patient Forward research and the perspective that Genomic Medicine is best used as a method to better define disease subsets( aka Selectivized Medicine), vis a vis genomics, so that hypotheses regarding therapeutics in these subsets can be tested , rather than the perspective that such analysis is sufficient to recommend a therapy to an individual patient. We have applied these lessons within the launch of a 400 dog prospective study of Hemangiosarcoma that is now underway and seeks to deliver curative outcomes to doges with splenic hemangiosarcoma. The approach towards Patient-forward Selectivized Medicine will be described and contrasted with the conventional perspectives on Precision Medicine.
To recognize that the use of genomic analysis of tumor, as part of a PMED drug matching approach, is unlikely to deliver much value to a patient, beyond a clinician's best guess.
To understand the difference between patient forward and model forward research.
To understand how the complexity of cancer in patients requires biological and clinical research in that cancer before an understanding of the altered genes in the cancer can add value to patient