Precision Oncology Needs to Grow Up: Time to Ditch the Sequencing Hype

Precision oncology entered the cancer scene with the promise of revolutionizing treatment by matching therapies to a patient’s genetic makeup. But here’s the hard truth: genomics-based precision oncology is fundamentally flawed. It doesn’t provide a complete picture of how cancer cells behave. It’s like trying to predict a sports game by analyzing player stats without watching them play. Yes, mutations matter, but knowing them doesn’t automatically lead to the right treatment.
For most genetic abnormalities, there are few—if any—effective drugs available. Worse, cancer cells evolve rapidly, often outpacing our ability to develop new therapies. While genetic profiles offer insights, they are far from the transformative tool they were once hyped to be.
Cancer Is Dynamic, Genetic Profiles Are Not: Genomics provides a static snapshot, but cancer is constantly adapting and changing. Genetic profiles offer limited value in understanding how cancer cells respond to treatments. If companies, particularly those in India, still cling to sequencing as the ultimate solution, they’re missing the point.
The real future of precision oncology lies in functional diagnostics—observing how cancer cells react to treatments and stressors in real-time. Growing a patient’s tumor in the lab, such as through organoids, and testing how it responds offers far more actionable insights than static sequencing ever could. To truly understand cancer’s complexity, we need to integrate metabolomics with genomics.
Metabolomics, the study of metabolic changes within cells, reveals how cancer cells use energy, survive under stress, and respond to treatments. Genomics tells us what could happen, while metabolomics shows us what is happening. This distinction is critical to tailoring effective therapies. For example, a genetic mutation might suggest a potential drug target, but metabolomics can tell us if the tumor is actually dependent on that metabolic pathway for survival. This distinction is critical to tailoring effective therapies.
Treat the Patient, Not Just the Mutation: Cancer treatment must evolve beyond viewing patients as a collection of mutations. Combining genomics, metabolomics, and functional diagnostics is the most promising path forward for true precision oncology. This holistic approach moves beyond the limitations of sequencing, offering the potential for personalized, dynamic cancer therapies. It’s time for precision oncology to grow up. The future lies in understanding the full picture—not just one piece of it.

ANKITA BANSAL

University/College name : Jio Institute