Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

The paradox of precision medicine

Nature Reviews Clinical Oncology volume 15, pages 341–342 (2018) Cite this article

Subjects

According to the paradigm of precision medicine, the administration of agents targeting the molecular alteration detected in a particular patient’s tumour reduces uncertainty in the clinical management of that patient. We describe how approaches to precision medicine can lead, paradoxically, to increased levels of uncertainty. We offer recommendations for how physicians can better navigate new uncertainties in precision medicine.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Harris, M. H. et al. Multicenter feasibility study of tumor molecular profiling to inform therapeutic decisions in advanced pediatric solid tumors: the individualized cancer therapy (iCat) study. JAMA Oncol. 2, 608–615 (2016).

    Article  Google Scholar 

  2. Hayes, D. F. et al. Breaking a vicious cycle. Sci. Transl. Med. 31, 196cm6 (2013).

    Google Scholar 

  3. Poonacha, T. K. & Go, R. S. Level of scientific evidence underlying recommendations arising from the National Comprehensive Cancer Network clinical practice guidelines. J. Clin. Oncol. 10, 186–191 (2011).

    Article  Google Scholar 

  4. Fleck, L. M. Personalized medicine’s ragged edge. Hastings Cent. Rep. 40, 16–18 (2010).

    Article  PubMed  Google Scholar 

  5. Fehrenbacher, L. et al. in 2017 San Antonio Breast Cancer Symposium Day 2 GS1-02 (San Antonio, TX, USA, 2017).

  6. Camidge, D. R. et al. Activity and safety of crizotinib in patients with ALK-positive non-small-cell lung cancer: updated results from a phase 1 study. Lancet Oncol. 13, 1011–1019 (2012).

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Le Tourneau, C., Kamal, M. & Bièche, I. The SHIVA01 trial: what have we learned? Pharmacogenomics 18, 831–834 (2017).

    Article  PubMed  CAS  Google Scholar 

  8. Bar-Hillel, M. & Fischhoff, B. When do base rates affect predictions? J. Pers. Soc. Psychol. 41, 671–680 (1981).

    Article  Google Scholar 

  9. Kahneman, D. Thinking, Fast and Slow (Farrar, Straus and Giroux, New York, 2011).

    Google Scholar 

Download references

Acknowledgements

J.K. is funded by Genome Canada/Genome Quebec (PACEOMICS).

Author information

Authors and Affiliations

  1. Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada

    Jonathan Kimmelman

  2. Department of Social Studies of Medicine, McGill University, Montreal, Quebec, Canada

    Jonathan Kimmelman

  3. Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada

    Ian Tannock

Authors
  1. Jonathan Kimmelman
    View author publications

    Search author on:PubMed Google Scholar

  2. Ian Tannock
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Jonathan Kimmelman.

Ethics declarations

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kimmelman, J., Tannock, I. The paradox of precision medicine. Nat Rev Clin Oncol 15, 341–342 (2018). https://doi.org/10.1038/s41571-018-0016-0

Download citation

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41571-018-0016-0

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing