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Recent genome-wide profiling studies of pediatric ALL identified a number of novel genetic alterations that target key cellular pathways for lymphoid growth and differentiation and that are associated with treatment outcome [ 6].
Cancer genomes are highly rearranged and are characterized by complex translocations and regional copy number alterations that target loci harboring cancer-relevant genes.
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One plausible explanation of this behavior is that an alteration that targets an affected pathway does not confer further selective advantage to the cancer cell.
A number of recent papers have revealed potential mechanisms of acquired resistance to RAF inhibitors: again, these mechanisms entail genetic alterations that circumvent target blockade by acting either on the target itself (BRAF amplification) or on analogous pathways (NRAS amplification or overexpression of COT, a MAPK pathway agonist).
These specific genetic pathway alterations that are the target of a drug are regarded as molecular companion diagnostic biomarkers.
However, the off-target alterations that result from Grx1 shRNA targeting result in significant alterations to the intracellular redox buffering capacity of the Grx1 knockdown cells.
Gröbner et al. found that about 50% of the tumours that they profiled harbour genomic alterations that can be targeted (directly or indirectly) by drugs that are available or under development.
Several non-GIST STSs have characteristic genetic alterations that can be targeted at a molecular level in patients who have failed conventional chemotherapy.
Of the highest clinical relevance is the capability of microarray approaches to identify pathogenically essential structures and alterations that can be targeted by future drugs that, hopefully, will lead to an improved management of these diseases.
Despite the great advance in the fight against MB resulting from molecular-based sub-grouping, additional efforts are needed to identify key biological alterations that could be targeted by tailored therapies.
These large-scale initiatives have identified rare genomic alterations that are potential therapeutic targets to guide individualized treatment.
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