Dana-Farber Cancer Institute, Boston, MA 02215, USA.
Oncology (Williston Park). 2010 Dec;24(14):1343-8.
The number of cancer patients and cancer survivors continues to increase rapidly amid predictions of a shortfall in physicians to care for them. In addition, newer cancer therapies have become increasingly complex and resource-intensive, compounding the impending workforce shortage. Simultaneously, the growing understanding of the biologic heterogeneity of cancer and the development of pharmacogenomics have opened up the possibility of personalized approaches to cancer diagnosis and treatment. Such personalization has been promulgated as a means of decreasing the cost of drug development, improving the efficacy of treatments, and reducing treatment toxicity. Although there have been notable successes, the fulfillment of these promises has been inconsistent. Providing care for future cancer patients will require the development of innovative delivery models. Moreover, new approaches to clinical research design, to the assessment of therapeutic value, and to the approval of and reimbursement for diagnostics and treatments are needed.
在预计医生人数不足以照顾癌症患者的情况下,癌症患者和幸存者的数量继续迅速增加。此外,新型癌症疗法变得越来越复杂,资源密集度也越来越高,这使得即将出现的劳动力短缺问题更加严重。与此同时,人们对癌症生物学异质性的认识不断提高,以及药物基因组学的发展,为癌症诊断和治疗的个性化方法提供了可能。这种个性化被宣传为降低药物开发成本、提高治疗效果和降低治疗毒性的一种手段。尽管已经取得了显著的成功,但这些承诺的兑现情况并不一致。为未来的癌症患者提供护理将需要开发创新的交付模式。此外,还需要新的临床研究设计方法、治疗价值评估方法,以及诊断和治疗的批准和报销方法。