Personalized Medicine for Colorectal and Breast Cancer

描述（由申请人提供）：本计划项目资助提案涉及个性化医疗-医疗保健，根据患者的个人特征，特别是他们的遗传学，对患者进行医疗干预。我们的目标是使用一种综合的跨学科方法来获得有关将乳腺癌和结直肠癌基因组信息转化为临床实践和卫生政策的关键方面的证据。我们的计划包括四个项目和两个核心，具体目标是： 目的1：通过使用基因组风险分层和靶向治疗来确定基因组风险分层和靶向治疗的利用率。 曲妥珠单抗（赫赛汀（r））的基因表达谱（GEP）和HER 2/neu检测示例 乳腺癌 目标2：了解对基因组检测和干预的偏好， 林奇综合征筛查的例子。 目标3：开发一个通用的，灵活的模型，用于评估个性化的成本效益 使用我们项目的独特数据，评估GEP、曲妥珠单抗HER 2/neu检测和Lynch综合征筛查的成本效益。 目标4：为将研究结果转化为实践和政策建立证据基础， 收集和综合有关临床应用以及监管、政策和经济方面的数据， 基于遗传的结直肠癌和乳腺癌干预措施的影响。 目标5：为项目提供资源：概念化、测量和调查人口 差异;进行定性和定量研究;确定和获取数据来源; 协调活动;传播调查结果。 这项建议的意义在于，我们的目标是建立基于证据的信息，这些信息将有助于患者、临床医生、提供者、研究人员和政策制定者评估个性化医疗如何才能最有益和最有效。我们的研究结果将产生超出特定癌症研究的影响，因为与利用，获取，偏好，经济学，价值和政策影响相关的问题与癌症部位和干预措施相关。

DESCRIPTION (provided by applicant): This Program Project Grant proposal addresses personalized medicine - health care targeting medical interventions to patients based on their individual characteristics, particularly their genetics. Our objective is to use an integrated, interdisciplinary approach to obtain evidence about key aspects of the translation of genomic information for breast and colorectal cancer into clinical practice and health policy. Our Program includes four Projects and two Cores with the Specific Aims to: Aim 1: Determine utilization of genomic risk stratification and targeted treatment by using the examples of gene expression profiling (GEP) and HER2/neu testing for trastuzumab (Herceptin(r)) for breast cancer. Aim 2: Develop an understanding of preferences for genomic testing and interventions using the example of Lynch-syndrome screening. Aim 3: Develop a generalized, flexible model for evaluating the cost-effectiveness of personalized medicine and estimate the cost-effectiveness of GEP, HER2/neu testing for trastuzumab, and Lynch syndrome screening using unique data from our Program Projects. Aim 4: Develop an evidence base for translating research findings into practice and policy by collecting and synthesizing data on the clinical applications and the regulatory, policy, and economic impacts of genetically based colorectal and breast cancer interventions. Aim 5: Provide Projects with resources for: conceptualizing, measuring, and investigating population differences; conducting qualitative and quantitative research; identifying and obtaining data sources; coordinating activities; and disseminating findings. The significance of this proposal lies in our goal to establish evidence-based information that will be useful to patients, clinicians, providers, researchers, and policymakers in assessing how personalized medicine can be most beneficial and efficient. Our results will have implications beyond the specific cancers studied, as the issues related to utilization, access, preferences, economics, value, and policy implications are relevant across cancer sites and interventions.