Toward theragnostics
Toward theragnostics
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DOI：
10.1097/ccm.0b013e3181921349
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发表时间：
2009-01-01
影响因子：
8.8
通讯作者：
Mira, Jean-Paul
中科院分区：
文献类型：
--
作者：
Pene, Frederic;Courtine, Emilie;Mira, Jean-Paul
治疗诊断学是一种将治疗学与诊断学相结合的治疗策略。它将识别最有可能受到新药物帮助或伤害的患者的诊断测试和基于测试结果的靶向药物治疗联系起来。生物信息学、基因组学、蛋白质组学和功能基因组学是分子治疗学进步所必需的分子生物学工具。这些工具生成诊断分析开发所需的遗传和蛋白质信息。治疗诊断学涵盖广泛的学科，包括个性化医疗、药物基因组学和分子成像，以开发有效的新型靶向疗法，为患者带来足够的益处/风险，并更好地从分子角度理解如何优化药物选择。此外，治疗诊断学旨在监测治疗反应，以提高药物疗效和安全性。此外，治疗诊断学可以消除对不适合治疗的患者进行不必要的治疗，从而为医疗保健系统节省大量药物成本。然而，将治疗诊断测试引入常规医疗保健需要证明成本效益和适当的可访问测试系统的可用性。这篇综述报告了肿瘤学和传染病领域的验证研究，这些研究证明了这种方法在明确的患者亚群中的益处，使该领域从药物开发过程转向临床实践和常规应用。治疗诊断学可能会改变制药公司通常的商业模式，从经典的重磅炸弹模式转向靶向治疗。 （《重症监护医学》2009 年；37[增刊]：S50-S58）
Theragnostics is a treatment strategy that combines therapeutics with diagnostics. It associates both a diagnostic test that identifies patients most likely to be helped or harmed by a new medication, and targeted drug therapy based on the test results. Bioinformatics, genomics, proteomics, and functional genomics are molecular biology tools essential for the progress of molecular theragnostics. These tools generate the genetic and protein information required for the development of diagnostic assays. Theragnostics includes a wide range of subjects, including personalized medicine, pharmacogenomics, and molecular imaging to develop efficient new targeted therapies with adequate benefit/risk to patients and a better molecular understanding of how to optimize drug selection. Furthermore, theragnostics aims to monitor the response to the treatment, to increase drug efficacy and safety. In addition, theragnostics could eliminate the unnecessary treatment of patients for whom therapy is not appropriate, resulting in significant drug cost savings for the healthcare system. However, the introduction of theragnostic tests into routine health care requires both a demonstration of cost-effectiveness and the availability of appropriate accessible testing systems. This review reports validation studies in oncology and infectious diseases that have demonstrated the benefits of such approach in well-defined subpopulations of patients, moving the field from the drug development process toward clinical practice and routine application. Theragnostics may change the usual business model of pharmaceutical companies from the classic blockbuster model toward targeted therapies. (Crit Care Med 2009; 37[Suppl.]:S50-S58)