Whoa. Okay, sometimes it comes up - "hey, have you seen anything out of the Apollo/Cancer moonshot thing yet?" We keep hearing they're doing HUGE multi-level projects and you'd assume those take a really long time. Turns out, I just don't keep up with Nature Genetics, because this huge, beautiful ultra-impressive study has been out for a while.
Genetics? "You mean that stuff we make fun of?" Yeah....but if you've got a cancer that tends to end up with nonfunctional mechanisms like double stranded DNA break repair because homogenous end joining just doesn't work anymore, you need to investigate this with genetics technologies. When DNA breaks checkpoints should activate to stop the cell from dividing. right? Then depending on how the DNA is broken you'll either activate HR (homogenous repair) or NHEJ (non-h end joining repair) and probably other processes that we didn't know about when I did my first postdoc on DNA repair proteins.
This study goes in depth into end-stage ovarian cancer from a multi-organ/multi-omics approach from autopsy samples. It is as comprehensive as it is depressing. My dog, there is so much heterogeneity in how these patients died.... looking through it, you feel like true personalized medicine is the only answer to keep someone alive once cancer gets to a certain point and the level of the study depth that we'd need to have for each individual is at a level that only Elmo Musk and Jerf Bozos would be able to afford it.
But the technology is here, and if you make a monumental effort you can use the technology to get the complementary insights to pull it all together. Seriously awesome and beautiful study even if it suggests how far we have to go.