Personalized medicine, scientific revolution or self-serving illusion: viewpoint from EORTC-PAMM Group
Abstract
Personalized medicine has redefined oncology by tailoring treatments to molecular and clinical characteristics. However, despite remarkable advances in biomarker discovery and targeted therapy, the integration of pharmacological principles into precision oncology remains limited. The resulting discrepancy between biological innovation and therapeutic optimization contributes to high attrition rates in drug development, inconsistent real world efficacy, and escalating financial toxicity. The European Organisation for Research and Treatment of Cancer Pharmacology and Molecular Mechanisms Group explored how pharmacology can bridge the gap between molecular precision and clinical reality. Although understanding mechanisms of action is a critical first step, the subsequent translation of this knowledge into individualized dosing and scheduling strategies and rational drug combinations is equally essential. Achieving this requires the use of quantitative tools, such as pharmacokinetic/ pharmacodynamic modeling, therapeutic drug monitoring, and real-world evidence (RWE). These patient-centered approaches enable continuous learning from patient data, refine our understanding of exposure-response relationships, and support adaptive treatment strategies across diverse populations. We also discuss the rise of tumor-agnostic approvals, which transcend histological boundaries yet expose disparities in national regulatory and reimbursement frameworks. Ensuring equitable access to mechanism-driven therapies requires harmonized policies integrating pharmacological, clinical, and ethical perspectives. True personalization in oncology requires moving beyond target selection to delivering the right dose to the right patient at the right time. Embedding holistic pharmacology approaches into the design evaluation and post marketing use of anticancer therapies will improve efficacy minimize toxicity and promote value-based care. Integrating mechanistic understanding with quantitative pharmacology and RWE represents the next frontier of precision oncology transforming innovation into sustainable patient-centered benefit pharmacokinetic/pharmacodynamic modeling precision oncology real-world evidence therapeutic drug monitoring tumor-agnostic therapy.
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BibTeX
@article{debien2026personalized,
title = {{Personalized medicine, scientific revolution or self-serving illusion: viewpoint from EORTC-PAMM Group}},
author = {V. Debien and A. Geraud-Cremieux and M. Le Grand and D. Carbone and I. Garajova and C. Pecoraro and E. Pasquier and G.J. Peters and E. Giovannetti and M. Centanni and J. Ciccolini},
journal = {ESMO Open},
year = {2026},
month = nov,
doi = {10.1016/j.esmoop.2026.108576},
url = {https://hal.science/hal-05849880v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Personalized medicine, scientific revolution or self-serving illusion: viewpoint from EORTC-PAMM Group
AU - V. Debien
AU - A. Geraud-Cremieux
AU - M. Le Grand
AU - D. Carbone
AU - I. Garajova
AU - C. Pecoraro
AU - E. Pasquier
AU - G.J. Peters
AU - E. Giovannetti
AU - M. Centanni
AU - J. Ciccolini
PY - 2026
DA - 2026/11/03
JO - ESMO Open
DO - 10.1016/j.esmoop.2026.108576
UR - https://hal.science/hal-05849880v1
AB - Personalized medicine has redefined oncology by tailoring treatments to molecular and clinical characteristics. However, despite remarkable advances in biomarker discovery and targeted therapy, the integration of pharmacological principles into precision oncology remains limited. The resulting discrepancy between biological innovation and therapeutic optimization contributes to high attrition rates in drug development, inconsistent real world efficacy, and escalating financial toxicity. The European Organisation for Research and Treatment of Cancer Pharmacology and Molecular Mechanisms Group explored how pharmacology can bridge the gap between molecular precision and clinical reality. Although understanding mechanisms of action is a critical first step, the subsequent translation of this knowledge into individualized dosing and scheduling strategies and rational drug combinations is equally essential. Achieving this requires the use of quantitative tools, such as pharmacokinetic/ pharmacodynamic modeling, therapeutic drug monitoring, and real-world evidence (RWE). These patient-centered approaches enable continuous learning from patient data, refine our understanding of exposure-response relationships, and support adaptive treatment strategies across diverse populations. We also discuss the rise of tumor-agnostic approvals, which transcend histological boundaries yet expose disparities in national regulatory and reimbursement frameworks. Ensuring equitable access to mechanism-driven therapies requires harmonized policies integrating pharmacological, clinical, and ethical perspectives. True personalization in oncology requires moving beyond target selection to delivering the right dose to the right patient at the right time. Embedding holistic pharmacology approaches into the design evaluation and post marketing use of anticancer therapies will improve efficacy minimize toxicity and promote value-based care. Integrating mechanistic understanding with quantitative pharmacology and RWE represents the next frontier of precision oncology transforming innovation into sustainable patient-centered benefit pharmacokinetic/pharmacodynamic modeling precision oncology real-world evidence therapeutic drug monitoring tumor-agnostic therapy.
SN - 2059-7029
ER -