Integrative Clinical Sequencing in the Management of Refractory or Relapsed Cancer in Youth

Abstract

Outcomes of children and young adults with cancer have improved, primarily due to enhanced understanding of tumor biology and due to the clinical application of biological discoveries through multi-institutional clinical trials.^1-4 However, survival for many pediatric oncology patients, including those with recurrent disease or metastatic disease, remains poor.^5,6 To this end, integrative sequencing modalities offer a potentially useful platform to investigate the individual cancer genome in order to identify actionable genomic alterations that can be matched to targeted therapies.^7-9 As such, the concept of precision medicine, ie, taking individual variability into account while designing therapy, is not new; however, post–genome-sequencing-era discoveries provide renewed opportunities for personalizing care of individuals with cancer.¹⁰ Precision medicine has been singled out as a priority initiative in the United States, with the goal of improving outcomes of hard-to-cure diseases, such as some pediatric cancers.¹¹