Predictive pathology of cytostatic drug resistance and new anti-cancer targets.

Due to continuous technical developments and new insights into the high complexity of many diseases, in particular the pathogenesis of cancer, molecular pathology is a rapidly growing field gaining centre stage in the clinical management of tumours as well as in the pharmaceutical development of new anti-cancer drugs. Activated signalling components are the targets for classical therapeutic agents and newly developed inhibitors. The application of the compounds in clinical trials has revealed promising results; however, the current diagnostic procedures available for determining which patients will primarily benefit from rational tumour therapy are insufficient. To read a patients' tissue as "deeply" as possible, gaining information on the morphology and on genetic, proteomic and epigenetic alterations will . be the new task of surgical pathologists experienced in molecular diagnostics, in order to provide the clinicians with information relevant for an individualized medicine. Among the different high-throughput technologies, DNA microarrays are now the first array approaches close to entering routine diagnostics. Technically advanced and well-established microarray platforms can now be evaluated by distinct bioinformatic tools capable of both identifying novel genes associated with disease development and also clusters of genes predicting the clinical outcome of an individual tumour. DNA microarrays have been efficiently used for the classification of tumour subtypes, the prediction of metastatic potential and drug response. In the current review we will focus in particular on the new possibilities of predicting the efficacy of anti-neoplastic drugs as a diagnostic tool of pathologists seeking an efficient individualized therapy.