Personalized medicine, precision medicine, or theranostics is a medical model that separates people into different groups with medical decisions, practices, interventions and/or products being tailored to the individual patient based on their predicted response or risk of disease. The terms personalized medicine, precision medicine, stratified medicine and P4 medicine are used interchangeably to describe this concept[1][2] though some authors and organisations use these expressions separately to indicate particular nuances.
While the tailoring of treatment to patients dates back at least to the time of Hippocrates, the term has risen in usage in recent years given the growth of new diagnostic and informatics approaches that provide understanding of the molecular basis of disease, particularly genomics. This provides a clear evidence base on which to stratify (group) related patients
Related Subjects : Precision Medicine, Genetics, Genomics, Precision Medicine, Novel Treatment, Proteomics and Genomics, Family Medicine, Ortho Medicine, Emergency medicine, Public Health
Personalized medicine to heart
Research on cardiovascular genetics has had some spectacular successes in uncovering new therapeutic targets—for example, the finding that people with inactivating mutations in the gene encoding the trafficking protein PCSK9 are at a much lower risk for heart attacks led to the development of antibody therapy targeting this protein. However, when it comes to personalizing treatment for cardiovascular disease on the basis of an individual patient's genetic makeup or biomarker data, there are currently only a handful of options where such an approach has proven to be clinically useful.
Related Subjects : Precision Medicine, Genetics, Genomics, Precision Medicine, Novel Treatment, Proteomics and Genomics, Family Medicine, Ortho Medicine, Emergency medicine, Public Health
There are currently three major approaches to T cell-based cancer immunotherapy, namely, active vaccination, adoptive cell transfer therapy and immune checkpoint blockade. Recently, this latter approach has demonstrated remarkable clinical benefits, putting cancer immunotherapy under the spotlight. Better understanding of the dynamics of anti-tumour immune responses (the "Cancer-Immunity Cycle") is crucial for the further development of this form of treatment. Tumours employ multiple strategies to escape from anti-tumour immunity, some of which result from the selection of cancer cells with immunosuppressive activity by the process of cancer immunoediting.
Apart from this selective process, anti-tumour immune responses can also be inhibited in multiple different ways which vary from patient to patient. This implies that cancer immunotherapy must be personalized to :
(1) identify the rate-limiting steps in any given patient,
(2) identify and combine strategies to overcome these hurdles.
(3) Proceed with the next round of the "Cancer-Immunity Cycle".
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Personalized medicine: Drug discovery and patient care.
Advances in human genome research are opening the door to a new paradigm for practising medicine that promises to transform healthcare. Personalized medicine, the use of marker-assisted diagnosis and targeted therapies derived from an individual's molecular profile, will impact the way drugs are developed and medicine is practiced. Knowledge of the molecular basis of disease will lead to novel target identification, toxic genomic markers to screen compounds and improved selection of clinical trial patients, which will fundamentally change the pharmaceutical industry. The traditional linear process of drug discovery and development will be replaced by an integrated and heuristic approach. In addition, patient care will be revolutionized through the use of novel molecular predisposition, screening, diagnostic, prognostic, pharmacogenomics and monitoring markers. Although numerous challenges will need to be met to make personalized medicine a reality, with time, this approach will replace the traditional trial-and-error practice of medicine.
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Personalized Medicine in Oncology
The development of cost-effective technologies able to comprehensively assess DNA, RNA, protein, and metabolites in patient tumours has fuelled efforts to tailor medical care. Indeed validated molecular tests assessing tumour tissue or patient germ line DNA already drive therapeutic decision making. However, many theoretical and regulatory challenges must still be overcome before fully realizing the promise of personalized molecular medicine. The masses of data generated by high-throughput technologies are challenging to manage, visualize, and convert to the knowledge required to improve patient outcomes. Systems biology integrates engineering, physics, and mathematical approaches with biologic and medical insights in an iterative process to visualize the interconnected events within a cell that determine how inputs from the environment and the network rewiring that occurs due to the genomic aberrations acquired by patient tumours determines cellular behaviour and patient outcomes.
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Pharmacogenomics & Personalized Medicine
The vision of personalized medicine, the practice of medicine where each patient receives the most appropriate medical treatments and the most fitting dosage and combination of drugs based on his or her genetic make-up, seems to become more realistic as our knowledge about the human genome rapidly expands. We already know the reason for many types of adverse drug reactions, which are often related to polymorphic gene alleles of drug metabolizing enzymes. Moreover, insight into reasons for poor drug efficacy, often related to single nucleotide polymorphisms or larger polymorphisms in genes encoding drug target proteins, has been gained. There is a growing need to incorporate this increasingly complex body of knowledge to the standard curriculum of medical schools, so that the forthcoming generation of clinicians and researchers will be familiar with the latest developments in pharmacogenomics and medical bioinformatics, and will be capable of providing patients with the expected benefits of personalized medicine.
Related Subjects : Precision Medicine, Genetics, Genomics, Precision Medicine, Novel Treatment, Proteomics and Genomics, Family Medicine, Ortho Medicine, Emergency medicine, Public Health