From molecular changes to customised therapy.

The revolution in molecular methods has allowed the development of approaches whereby cancer-specific changes can be utilised for targeted therapies. Gene therapy strategies include mutation compensation for correction of cancer-associated defects, and molecular chemotherapy for delivering toxic substances locally to tumour cells. Viruses which replicate only in tumour cells represent a powerful novel approach undergoing intensive development, with some exciting clinical results. Cancer vaccines are promising, although the final clinical evidence is still pending. Monoclonal antibodies, in conjunction with chemotherapeutics, are becoming standard therapy. Recently, the first small molecular inhibitors have made clinical breakthroughs. Importantly, the large amount of information available on genes differentially expressed in cancer cells, allows correlation of prognosis and treatment responses to molecular changes. Thus, the future of cancer treatment could be customised treatment based on the molecular properties of the tumour, utilising combinations of novel and conventional agents.