Cancer Prevention with Molecular Target Therapies 3.0

Today, the oncologist is like a detective of the human body who, instead of a magnifying glass, uses the new tools of molecular pathology to search not only for genes or molecular targets, to be targeted with innovative anticancer therapies, but also molecular alterations that allow the identification of population groups at risk of developing tumors for preventive purposes. This is the precision oncology thanks to which it is possible today to aim at treatments but also at personalized cancer prevention, based on precision medicine models, through the identification of specific genomic determinants linked to an increased risk of developing cancer. This area includes a series of interventions to identify cancer at an early stage or to avoid the onset of the disease. Molecular pathology is a cornerstone of precision oncology, and today, it is necessary to study not only the single alterations but also the overall modifications of the cellular signal transduction pathways. In this way, the molecular pathologist can provide the clinician with crucial information to drive the therapeutic choice. The so-called histological model, which has long-governed clinical research in oncology and clinical practice, is now flanked by the molecular model. In this approach, the starting point is represented by the organ from which the neoplasia originates, followed by the histological examination, the identification of any molecular alterations and the choice of the drug, through a path of selecting patients who are more likely to respond to treatment. Targeted anticancer therapies are currently at the heart of the development of many anticancer drugs including hormone therapies, signal transduction inhibitors, gene expression modulators, apoptosis inducers, angiogenesis inhibitors, immunotherapies and toxin-releasing compounds. It is important to note that targeted cancer therapies have some limits concerning the possibility of acquired resistance to the treatment. Additionally, it is possible to use molecular targeted therapy in combination with one or more traditional chemotherapy drug. Another limitation of targeted therapy is that drugs for some identified targets are difficult to develop due to the structure of the target and/or the way its function is regulated by the cell. The purpose of this Special Issue was to highlight the importance of research aiming at discovering new and more informative methods of diagnostic molecular testing, targeted therapies mainly in early-stage disease and future directions for precision oncology approaches to understand the tumor evolution and the possible related therapeutic resistance.