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RESEARCH PRODUCT

Cancer: Clinical Background and Key Challenges

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This chapter is aimed at a wide audience ranging from biologists to medical students and cancer specialists. It provides a comprehensive overview of systems approaches to the pathology and treatment of cancer. In particular, it addresses diagnosis and therapy by interconnecting various aspects of cancer at both the molecular and clinical level, and contrasts the unifying features of malignancies with the daunting diversity of cancer types, stages, and evolutionary processes during treatment. The importance is emphasized of both prevention and innovative treatments in reducing the cancer burden, and of early detection as the link between these two major areas. It sets the stage for analysis of cancer by means of systems biology, bioinformatics, and systems medicine. These methods involve the processing of cytological, histological, and imaging data, combined with genetic and expression profiling. The application of systems approaches to cancer-related clinical practice and research is discussed. The necessity is demonstrated for signalling pathways analysis to be fully integrated into grading and clinical staging of cancers, as well as into the process of discovering novel targets and biomarkers for diagnosis and prognosis. Key challenges and limitations are outlined for systems approaches to cancer, and areas are indicated where research needs to be focused in the future. Finally, pointers are provided to the paths that must be followed in order to move from a carefully controlled biological investigation, to approaches and technologies that will eventually accelerate the translation of new discoveries into prevention and clinical applications.