The diagnosis and monitoring of cancer benefit from this new reality. While commonly based on histology of biopsied tissues and blood tests cancer diagnosis and monitoring is increasingly enhanced by high resolution imaging technologies such as computed tomography, ultrasound, positron emission tomography, and magnetic resonance imaging that can detect and characterize abnormal tissues non-invasively. Multi-modal and molecular imaging technologies provide additional advantages in the spatial and temporal characteristics of in vivo processes that are biomarkers of disease. For example, researchers are using magnetic resonance spectroscopy in clinical trials to monitor the dynamic reaction of pyruvate metabolism to lactate to quantitatively image the aggressiveness of prostate cancer less than a decade after the initial proof of principle. This powerful non-invasive imaging technology, which resulted from the convergence of physics, engineering, chemistry with clinical science, is rapidly emerging as a generalizable method for imaging the “Krebs cycle” and other metabolic pathways in vivo.
Drug development and delivery using targeted molecular therapeutics is another example of converging technologies emerging today. Therapeutics for a number of cancers, most notably breast, prostate, and non-small cell lung cancer have been developed to target signal transduction, protein expression, and cell proliferation. Therapeutic agents must be physically, chemically, and biologically engineered for delivery to the site of action where cell entry, stability, bio-distribution, and clearance contribute to their overall efficacy. Multifunctional delivery systems with targeted therapeutic payloads have been developed and many show promise in clinical use.
The path towards comprehensive precision medicine will require the convergence of many fields of science in order to develop new technologies that characterize disease at the personal level and map the underlying causes rather than the physical signs and symptoms. The first examples of change are now on the horizon.