Individualized drug combinations improve cancer treatment outcomes

Individualized drug combinations improve cancer treatment outcomes

Researchers at the University of California San Diego School of Medicine have led the world's first clinical trial showing that cancer drugs can be safely and effectively personalized based on the unique DNA of a patient's tumor.

The study results, published in the online edition of January 8, 2026Journal of Clinical Oncologyfound that individualizing multidrug treatments to each patient's specific tumor mutations using molecular testing can significantly improve treatment outcomes.

Every patient and every cancer is unique, and so is the way we treat them. Our results show that precision oncology is achievable at the individual level. If each patient’s treatment is based on the unique DNA of their tumor, we can treat cancer with greater precision.”

Jason Sicklick, MD, senior author of the study, professor of surgery and pharmacology at UC San Diego School of Medicine and surgical oncologist at UC San Diego Health

The clinical trial, known as Investigation of Profile-Related Evidence Determining Individualized Cancer Therapy (I-PREDICT), used advanced genomic sequencing to identify the genomic changes that trigger each person's cancer. Doctors then developed personalized treatment plans using FDA-approved medications, carefully adjusting dosages for each patient to specifically target these molecular changes—the opposite of a one-size-fits-all approach.

In a cohort of 210 treated patients with advanced cancer, almost 95% had different tumor DNA profiles - no two cancers were the same. This resulted in 157 different treatment regimens, including 103 new drug pairings that had never been tested together before. Patients whose therapies best matched their tumor mutations achieved better treatment outcomes and improved their chances of response and survival. Importantly, patients who received new drug combinations did not experience more serious side effects than those who received standard therapies.

The study also found that starting new drug mixtures at lower doses and carefully increasing them over time ensures the safety of treatments, even for therapies that have never been used together before.

“The I-PREDICT study shows what is possible when we let a patient’s biology guide treatment,” said Shumei Kato, MD, associate professor of medicine at UC San Diego School of Medicine and medical oncologist at UC San Diego Health. “By using biomarkers to select drugs and adjust dosage, we can develop combinations that precisely target the cancer drivers in each person.”

“Innovative clinical trial design is a core part of our work at Moores Cancer Center,” said Diane Simeone, MD, director of the Moores Cancer Center at UC San Diego Health. "This study reflects the strength of our multidisciplinary, team-based approach that combines scientific leadership, clinical trial expertise and the infrastructure necessary to bring discoveries directly to patients. It is a powerful example of how we are shaping the future of precision oncology and putting the patient at the center of every decision."

Both Sicklick and Kato are members of the UC San Diego Moores Cancer Center, which served as a key partner in supporting the clinical trial.

Moores Cancer Center at UC San Diego Health is the region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center. They consistently rank among the top 50 in the country for cancer careUS News and World Report.

Sicklick, who is also co-leader of the Structural and Functional Genomics Program at Moores Cancer Center, adds that this research represents a game changer for cancer treatment.

“Instead of a one-size-fits-all solution, we’re moving toward a one-size-fits-all solution,” Sicklick said.

The research builds on previous findings published inNatural medicine(2019) andGenomic medicine(2022), who analyzed subsets of the I-PREDICT cohort. The new publication expands this work to include more patients and longer follow-up, while providing detailed guidance on how other organizations can adopt precision strategies for cancer treatment.

This study lays the foundation for a future randomized trial designed to confirm the benefits of this personalized precision oncology approach.

Additional co-authors of the study include Daisuke Nishizaki, Hirotaka Miyashita, Ryosuke Okamura, Michael E. Hahn, Mina Nikanjam, Paul T. Fanta, David E. Piccioni, Hitendra Patel, Ramez N. Eskander, Rana R. McKay, Jeffrey S. Ross, J. Jack Lee, Scott M. Lippman, Shumei Kato and Razelle Kurzrock, MD, all at UC San Diego.

Financial support for the study came in part from Foundation Medicine, the Joan and Irwin Jacobs Foundation, Jon Strong, and the National Institutes of Health (P30 CA023100).

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