Portfolio Manager Insights

Genetics is revolutionizing the treatment of cancer

Cancer treatment, long dominated by broad-brush treatments with serious side effects, is being reshaped by targeted therapies made possible by advances in genetics, says Fidelity’s Eirene Kontopoulos.

By: Eirene Kontopoulos
Updated: 10/19/2026
  • Advances in genetics, the study of genes and heredity, have led to targeted treatments for certain types of cancer that can avoid the serious side effects associated with more traditional therapies, according to Fidelity Portfolio Manager Eirene Kontopoulos, who believes companies leading this innovation have become attractive investments.
  • “With targeted genetic therapies, once-fatal diagnoses have been transformed into manageable chronic conditions, and I believe we’re just getting started in this promising field,” says Kontopoulos, who manages Fidelity Advisor® Biotechnology Fund. “Many people are now living 20 or even 30 years with cancer, while maintaining an excellent quality of life.”
  • In leading the industry-focused equity strategy, she follows an investment approach rooted in the belief that successful biotechnology investing requires a competitive edge in understanding the science behind therapies, the likelihood of clinical success and the size of the addressable market. She argues these factors can improve the probability of identifying value-creation opportunities. She emphasizes companies developing the most innovative therapies, where the benefits to society can far outweigh the costs to the health care system.
  • Kontopoulos says the emergence of genetically informed targeted therapies means that, in some cases, patients can receive a drug designed to specifically shut off the disease-driving mechanism, helping to extend both survival and quality of life.
  • “Chemotherapy and radiation were designed to kill cancer cells, but they also harm healthy cells and can weaken patients in various ways,” explains Kontopoulos, who holds a doctorate in neuroscience from Harvard Medical School. “Now, cancer patients can be tested to determine which mutation is driving the disease.”
  • For example, the five-year survival rate of chronic myeloid leukemia patients has jumped from 22% to about 70% with tyrosine kinase inhibitors, according to Kontopoulos. She also notes that the five-year survival rate for metastatic melanoma has more than doubled, from 16% to 35% or higher, through genetically guided immunotherapies.
  • Reflecting the growing impact of personalized medicine, one position Kontopoulos began building earlier this year was Revolution Medicines, a pioneer in precision small-molecule therapies targeting RAS-addicted cancers. Its recently approved RAS(ON) multi-selective inhibitor, daraxonrasib, directly targets active mutant RAS variants across several historically difficult-to-treat solid tumors, she says. The stock was a top-10 holding as of September 30, 2026.
  • “By effectively shutting off the underlying oncogenic driver present in about 90% of cases, I believe daraxonrasib has the potential to revolutionize the treatment of metastatic pancreatic ductal adenocarcinoma, currently one of oncology’s deadliest diagnoses,” she concludes.
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