By the time most cancer patients visit Daniel van Hoff at his clinic, they have on average twelve more weeks to live.

So when it comes to the promise of genomic medicine, the clinical oncologist and his patients are understandably impatient. "These are patients who have exhausted all standard therapies," van Hoff explained, so he wants to use the genetic information gleaned from their biopsies "to work as hard as possible to find the Achilles' heel in these tumors."

A decade after the first draft of the human genome was published, researchers speaking at the 2012 AAAS Annual Meeting say they have uncovered hundreds of these molecular vulnerabilities, and van Hoff said "scientists bring us new agents every week" to test as therapies.

The price of gene sequencing has plummeted since 2001, at the same time that scientists have learned much more about the genetics of normal and diseased human tissue, said William Beck, a molecular pharamacologist at the University of Illinois at Chicago. Major clinics like van Hoff's Translational Genomics Research Institute (TGen), he said, "now sequence the tumors of almost every patient who walks in the door."

And increasingly, research clinicians like van Hoff are finding molecular therapies to use against the very worst tumors. In late January, the U.S. Food and Drug Administration approved a new medication called vismodegib for treating advanced basal cell carcinoma--a medicine that was first tested at TGen, van Hoff said. "We are applying these molecular tools for patients sitting in front of us right now."

Van Hoff cited studies showing that even patients who had received extensive treatments for their cancers could benefit from molecular profiling of their tumors. In one study, 74% of the patients had at least one potential gene variation that could be targeted by therapy, and van Hoff said molecular profiling can slow the advance of cancer and extend the lives of some patients.

In some cases, he said, there were surprising differences in what therapies "a doctor might select versus what molecular targeting would recommend."

Still, van Hoff was careful to acknowledge what he called "the failures" of new research, displaying a long list of his former patients--many of them remembered with personal anecdotes--who died from their intractable tumors.

One of the biggest challenges of molecular treatments for cancer has been finding a way "deliver these molecules to specific targets in cells," Beck said.

One promising treatment, using snippets of RNA molecules to silence the genes that have gone awry in tumor, was the subject of billion-dollar investments by pharmaceutical companies such as Merck and Novartis in 2007, he said. But many companies have since cut back their spending on RNA silencing, in part because it has been difficult to develop ways to deliver the therapy.

Academic researchers, the speakers agreed, are now providing the cutting-edge research in RNA silencing treatments. Anil Sood, a gynecologic oncologist at the University of Texas M.D. Anderson Cancer Center, has turned to nanotechnology to find ways to package small interfering RNA molecules that can quiet rebelling tumor genes.

Sood and University of Washington researcher Patrick Stayton are testing a variety of ways to deliver the RNA molecules directly to tumors, from nano-sized capsules of chitosan--a material derived from the shells of crab and shrimp-- to polymers designed to dissolve barriers inside cells and release targeted chemotherapy.

Their experiments and many others like them, Beck said, have brought the idea of personalized medicine closer to the reality imagined when the human genome was first sequenced. "We're getting closer to having more effective medicines with fewer side-effects."