engleski

Considering precision medicine in the setting of systemic disease – missing puzzles

Understanding cancer biology in 21st century is still a very difficult task. While clinical medicine needs to find ways for dealing with this disease at many levels, molecular medicine has been mostly focused on mutational analyses extending to research related to transcriptome/proteome/ interactome studies. All these efforts have been concentrated on discovering early diagnostic markers and improving disease treatment. In 2011, two hallmarks of cancer: reprogramming of energy metabolism and evading immune destruction were added to the previous six hallmarks, which were proposed by Hanahan and Weinberg in 2000. Currently, the cancer’s cell metabolism and its “hiding” from the host’s immunological system, tend to be the basis for understanding the pathophysiology of seemingly unrelated signs of systemic disturbance which we diagnose as “cancer”. Several top-quality papers published in 2016/2017 strongly shed new light on an old hypothesis, officially suggested back in 1931, that cancer may represent a systemic disease. This new data must be considered in the setting of the human microbiome. Not understanding all its roles and functions, especially those related to the existence and/or absence of specific metabolites, may be an important gap in elucidating the most important aspects of cancer. Some of these issues, which should be viewed as “missing puzzles”, will be explained and carefully discussed.

precision medicine ; cancer ; reprogramming of energy metabolism

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