Fabrice Andre, Head of Research Division at Institut Gustave Roussy, shared on LinkedIn:
“Eight questions that define success in the field of Personalized Cancer prevention. Key slide by Timothy Rebbeck during The Lancet/Gustave Roussy Lecture last friday.”
Eight Questions That Will Define Success
- Risk estimates: Are they rigorous and valid across populations?
- Risk thresholds: When should we act, and who decides?
- Mortality: Does screening save lives, or just diagnose earlier?
- Care pathways: Who cares for people before cancer develops?
- De-escalation: Can we safely do less without inertia, distress, or legal fears?
- Communication: Can patients understand risk and choose what matters to them?
- Payment: Will systems fund prevention with benefits decades away?
- Equity: Will everyone benefit, and who is accountable?
Miguel Bronchud, Veteran Cancer Clinician and Researcher, added:
“Thank you for sharing, Fabrice.
But: What makes early cancers ‘invisible to our immune systems‘, or our immune systems incapable to stop them from developing and spreading locally or to distant metastatic sites?
Again, more research is needed. From any possible angle but especially from the perspective of our own immune system.
After all, a tumor truly becomes ‘cancer’ when cells behave in a ‘malignant fashion’ and invade both local tissues, or spread to loco regional LNs or distant organs.
Both these processes require not only the ‘proliferation/dedifferentiation’ traits, but also the failure of our own immune system to stop them.
Placental immune editing switches (PIES) have not evolved to prevent or to cause cancer but to make feto-maternal immune tolerance possible, which is at the very core of our placental mammalian (‘Eutherian’) nature.
Aggressive epithelial cancers might be an unfortunate ‘side effect’ of this highly sophisticated biological nature? Microenvironmental properties in the placenta and decidua are thought to be a key to feto-maternal immune tolerance.
Can they be co opted during carcinogenesis?”
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