Comment in Nature: the naming of cancers need to change

A shift is required from using organ-based classifications of cancer to using molecular-based ones, argue prof. Fabrice André and colleagues in de Comment in Nature. ‘Classifying cancers according to their molecular characteristics would expedite the access of millions of people to effective treatments’. There is a growing disconnect between classifying cancers according to wich organ they originate in and developments in precision oncology, which uses the molecular profiling of tumor and immune cells to guide therapies. The authors highlight the case of nivolumab, which can lead to high response rates in tumors with expression of PD-L1. Yet ‘for about a decade millions of patients with tumors expressing high levels of PD-L1 were not able to access nivolumab because clinical trials had not yet been conducted for their type of cancer as conventionally defined. A similar story has played out with most of the drugs tested in clinical trials over the past decade. Changing cancer classification could also facilitate patients understanding of their cancer and therapy. The authors conclude that changing how cancers are classified is the first step toward precision oncology and a deeper biological understanding of cancers.