The molecular genetics of cancer: down the rabbit hole

Extract

Received 6 February 2001; Accepted 6 February 2001.

OVERVIEW

Like Alice in Wonderland, researchers in the molecular genetics of cancer may feel that each discovery leads to a ‘curiouser and curiouser’ set of questions. The initial celebration that follows the discovery of a gene mutation associated with a cancer soon gives way to perplexity upon learning that mutations in this gene only account for some (usually small) percentage of cancer cases. In addition, different mutations in the same gene do not always cause the same phenotype, or respond in the same way to therapeutic agents, making patient care increasingly difficult. Epigenetic phenomena that are potentially reversible further complicate the matter, as do gene–environment interactions. Nevertheless, there is a strong motivation to study these disorders, for they teach us how all cells work by showing how processes can go wrong, and have the potential to lead to crucial breakthroughs in care and treatment. This special review issue first examines new tools that researchers are using to make these discoveries, followed by epigenetic phenomena that are common to a number of cancers. Next, this issue explores the latest developments in two ‘complex’ syndromes, breast cancer and colon cancer. Finally, several reviews update the new complexities involved in a number of ‘single-gene’ cancers (are they really?), and then detail the state-of-the-art in gene therapy for one set of cancers, specifically involving the brain.