Utilizing the molecular gateway: the path to personalized cancer management.
Utilizing the molecular gateway: the path to personalized cancer management.
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DOI：
10.1373/clinchem.2008.118554
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发表时间：
2009-04
影响因子：
9.3
通讯作者：
Lee JK
中科院分区：
文献类型：
--
作者：
Overdevest JB;Theodorescu D;Lee JK
个性化医学是根据个体的基因构成提供有针对性的预防、检测、预后和治疗努力。个性化医疗的实现将需要将患者的传统临床数据与基于生物信息学的分子评估简档相结合。这种协同方法提供了实实在在的好处，例如提高了癌症亚型分子分类的特异性，改善了预后准确性，有针对性地开发新疗法，旧疗法的新应用，以及量身定制的化疗药物的选择和交付。在后基因组时代，通过生物技术的进步，我们个性化癌症管理的能力正在迅速扩大。基因组学、蛋白质组学、单核苷酸多态分析和单倍型图谱、高通量基因组测序和药物基因组学平台构成了对患者肿瘤进行分子评估的机制。在这些评估过程中得出的补充数据通过生物信息学分析进行处理，以提供独特的见解，将表达谱与疾病检测、肿瘤对化疗的反应和患者生存联系起来。总而言之，这些方法提高了医生评估风险、靶向治疗和定制化疗疗程的能力。随着新的生物信息学模型提供的见解与目前评估和治疗癌症患者的程序相结合，个性化医学有望快速增长。整合这些生物平台将需要改进组织处理和分析技术，特别是在临床病理学方面，以克服定制我们治疗癌症的能力方面的障碍。
Personalized medicine is the provision of focused prevention, detection, prognostic, and therapeutic efforts according to an individual’s genetic composition. The actualization of personalized medicine will require combining a patient’s conventional clinical data with bioinformatics-based molecular-assessment profiles. This synergistic approach offers tangible benefits, such as heightened specificity in the molecular classification of cancer subtypes, improved prognostic accuracy, targeted development of new therapies, novel applications for old therapies, and tailored selection and delivery of chemotherapeutics. Our ability to personalize cancer management is rapidly expanding through biotechnological advances in the postgenomic era. The platforms of genomics, proteomics, single-nucleotide polymorphism profiling and haplotype mapping, high-throughput genomic sequencing, and pharmacogenomics constitute the mechanisms for the molecular assessment of a patient’s tumor. The complementary data derived during these assessments is processed through bioinformatics analysis to offer unique insights for linking expression profiles to disease detection, tumor response to chemotherapy, and patient survival. Together, these approaches permit improved physician capacity to assess risk, target therapies, and tailor a chemotherapeutic treatment course. Personalized medicine is poised for rapid growth as the insights provided by new bioinformatics models are integrated with current procedures for assessing and treating cancer patients. Integration of these biological platforms will require refinement of tissue-processing and analysis techniques, particularly in clinical pathology, to overcome obstacles in customizing our ability to treat cancer.