Personalized oncology: Recent advances and future challenges
Personalized oncology: Recent advances and future challenges
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DOI：
10.1016/j.metabol.2012.08.016
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发表时间：
2013-01-01
影响因子：
9.8
通讯作者：
Kalia, Madhu
中科院分区：
文献类型：
--
作者：
Kalia, Madhu
个性化肿瘤学是以证据为基础的个性化医学，在正确的时间为正确的癌症患者提供正确的护理，并导致可衡量的结果改善和医疗保健成本降低。在个性化肿瘤学，如基因组分析，靶向药物，癌症治疗和分子诊断学的不断发展的主题将在这篇评论中进行讨论。生物标志物和分子个体化医学正在取代传统的“一刀切”医学。在接下来的十年里，癌症的治疗将从被动的学科转向主动的学科。个性化肿瘤学的本质在于生物标志物的使用。这些生物标志物可以来自组织、血清、尿液或成像，必须经过验证。基于生物标志物的个性化肿瘤学已经产生了显着的影响。三种不同类型的生物标志物特别重要：预测性、预后性和早期反应生物标志物。实施基于遗传和分子诊断和干预的先发制人医学的工具将改善癌症预防。计算机断层扫描（CT）和正电子发射断层扫描（PET）等成像技术已经影响了癌症患者的早期检测和管理。成像的未来进展预计将在分子成像，综合诊断，生物驱动的介入放射学和治疗诊断学领域。分子诊断识别个体癌症患者更有可能对靶向化疗产生积极反应。分子诊断包括检测基因、基因表达、蛋白质和代谢物。伴随分子诊断的使用预计将在未来显着增长，并将整合到新的癌症治疗中，这将提供更高的效率，价值和成本节约。这种方法代表了一个独特的整合机会，增加了个性化肿瘤学的价值。(C)2013 Elsevier Inc. All rights reserved.
Personalized oncology is evidence-based, individualized medicine that delivers the right care to the right cancer patient at the right time and results in measurable improvements in outcomes and a reduction on health care costs. Evolving topics in personalized oncology such as genomic analysis, targeted drugs, cancer therapeutics and molecular diagnostics will be discussed in this review. Biomarkers and molecular individualized medicine are replacing the traditional "one size fits all" medicine. In the next decade the treatment of cancer will move from a reactive to a proactive discipline. The essence of personalized oncology lies in the use of biomarkers. These biomarkers can be from tissue, serum, urine or imaging and must be validated. Personalized oncology based on biomarkers is already having a remarkable impact. Three different types of biomarkers are of particular importance: predictive, prognostic and early response biomarkers. Tools for implementing preemptive medicine based on genetic and molecular diagnostic and interventions will improve cancer prevention. Imaging technologies such as Computed Tomography (CT) and Positron Emitted Tomography (PET) are already influencing the early detection and management of the cancer patient. Future advances in imaging are expected to be in the field of molecular imaging, integrated diagnostics, biology driven interventional radiology and theranostics. Molecular diagnostics identify individual cancer patients who are more likely to respond positively to targeted chemotherapies. Molecular diagnostics include testing for genes, gene expression, proteins and metabolites. The use of companion molecular diagnostics is expected to grow significantly in the future and will be integrated into new cancer therapies a single (bundled) package which will provide greater efficiency, value and cost savings. This approach represents a unique opportunity for integration, increased value in personalized oncology. (C) 2013 Elsevier Inc. All rights reserved.