Genomic Diagnostics of Cancer

Genomic diagnostics has become a major milestone in prediction and treatment of cancer. This is due to the steady decreasing prices of the recent Next Generation Sequencing technology allowing parallel analysis of hundreds of genes in a single patient, but also to the developments of new treatment approaches in cancer not responding to first line therapy. About 10% of all cancers have a strong genetic background and are heritable cancers. Genetics has the responsibility to define these patients for better management of the patient commonly being interdisciplinary, and for advising family members. This goes far beyond the commonly BRCA1/2 testing in breast cancer and is more and more directed towards combination of different cancers in one family. About 100 inherited cancer genes are known which require special attention of the health care system. National and international networks have been formed to address these more complex prevention strategies and to define the true cancer risk for different organs in the respective families. However, genomic technologies today allow somatic mutation analysis of basically all genes in cancer tissue to predict response (resistance, susceptibility) to many newly developed drugs. Here genetics serves as companion diagnostics such as for melanoma, ovarian cancer, or lung cancer. These developments reach true individualized treatment strategies such as peptide vaccination against mutated proteins of a single tumor. In my talk I will give examples as well of cancer prediction and prevention as a general health strategy, but also for personalized cancer treatment.