Taking action on actionable mutations: a French initiative on universality in precision cancer care

The reality of precision or personalized cancer care is here. The discovery of oncogenic drivers (such as BCR-ABL translocations in chronic myelogenous leukemia, kinase domain mutations of the epidermal growth factor receptor (EGFR) gene or EML4-ALK fusion genes in lung adenocarcinoma, and BRAF V600E mutation in melanoma) has revolutionized the field of cancer biology. These drivers have led to new paradigms in cancer treatment (Table 1). Tumours that harbor these genomic aberrations, now commonly referred to as “actionable mutations”, are highly dependent for their growth and survival on the function of the protein products of these mutated driver genes (1). Patients with driver-addicted tumours can benefit from drugs that specifically inhibit the function of these driver genes, and a high percentage experiences significant treatment response and prolongation of survival.