《肿瘤瞭望》：目前仅一小部分被发现的基因组改变具有临床意义，请您谈谈如何将这些改变真正用于临床。

　　Levine教授：这就是为什么我们要把所有的数据进行汇总、以尽可能保证其突变的准确性及多样性的原因。我们获得的决定基因突变的可用性信息越多，我们就能越快将其应用到世界范围的患者上。

　　我认为基因组学发展迅速、前景好、且操作越来越简易。正因为它的发展，我们才可以讨论未来的各种可能，但是我们还需要努力去超越现有的成果，将今日之不可能变成明日之可能——当下就是我们的机遇。我相信，对于医疗工作者、研究者以及患者而言，我们都处在一个最好的时代，这里充满机遇和便利，我们有责任去充分发挥它的优势。

　　That’s why I think we need to get all of our data together in a format where we can really ensure that our sphere of actionable mutations is as accurate and as large as possible. And the more information we have that we can disseminate about those actionable lesions， the faster we can bring that to patients everywhere worldwide.

　　I think genomics is getting faster and better and easier all the time， so we can always argue and talk about what’s possible today， but we always have to push it and ask what’s not possible today could easily be possible tomorrow. And that’s the exciting opportunity that what we can’t do now may be done by next year exactly at this meeting. I think there’s just never been a better time for all of us in research， in clinical care， for our patients， for families—that this era really is a tremendous opportunity and privilege and it’s our responsibility to take advantage of it for everybody.

　　《肿瘤瞭望》：您认为未来肿瘤的评估是否可能一个评估基因组学和表观基因组学改变的过程？

　　Levine教授：目前我们正在朝这一目标去发展，但我认为未来肿瘤的评估却不限于此，它需要病理组织学检查、肿瘤表观遗传学、基因组学，以及影像学检查需要有机地结合，更需要临床医生对患者的问诊与体检，没有哪一个独立的因素将成为肿瘤诊断的唯一手段。从这一角度上而言，基因组学和表观基因组学可成为评估肿瘤的一种新型工具。

　　I think it’s all going to be a part of it. I think we’re going to have to look at tumors under the microscope， we’re going to need epigenetics， genetics， we’re going to need scans， we’re going to need to be doctors and examine our patients. No one parameter is ever going to be the answer. This is just another tool as part of the assessment of the patient and their disease.

　　《肿瘤瞭望》：您能描述一下新一代基因组学药物会是什么样的吗？

　　Levine教授：于我而言，新一代药物的问世需要以下两项主要条件：首先，我们需要获取大量的临床信息，不是数十个、数百个的病例资料，而是成千上万的患者临床信息，唯此我们才能获得强有力的预测指标；其次，我们需要拓宽进入基因平台的途径——不论患者身在何处，我们甚至不需要知道患者的地点、是否可享用基因平台和花费，所有患者都能从平台中获益、任何人都可以利用其信息。

　　Well， to me， there’s two parts of the next phase. The first is: we need to get information， not on tens or hundreds of patients， but on thousands and tens of thousands of patients together by combining data sets and getting robust predictors. We also need to increase access to the genomic platforms—whether our patients are in New York City in a large academic center or in Kansas or in Fiji—that we have access to that genomic platform no matter where the patients is so that it’s not knowing where it is， or availability of the platform， or cost that everyone can get that profiling done and everyone can use that information.

　　专家简介：Ross L. Levine， MD  美国纪念斯隆-凯特琳癌症中心肿瘤专家、Laurence Joseph Dineen白血病研究主席，主要研究领域涉及骨髓恶性肿瘤的基因组学研究及治疗，尤其擅长骨髓增殖性肿瘤的治疗。