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个性化医疗:从基因迈向药物

Personalized medicine: Striding from genes to medicines.

作者信息

Nair Sunita R

机构信息

Cardiff Research Consortium (Knowledge Services), Capita India.

出版信息

Perspect Clin Res. 2010 Oct;1(4):146-50. doi: 10.4103/2229-3485.71775.

Abstract

Personalized medicine has the potential of revolutionizing patient care. This treatment modality prescribes therapies specific to individual patients based on pharmacogenetic and pharmacogenomic information. The mapping of the human genome has been an important milestone in understanding the interindividual differences in response to therapy. These differences are attributed to genotypic differences, with consequent phenotypic expression. It is important to note that targeted therapies should ideally be accompanied by a diagnostic marker. However, most efforts are being directed toward developing both these separately; the former by pharmaceutical companies and the later by diagnostic companies. Further, this companion strategy will be successful only when the biomarkers assayed are differentiated on a value-based approach rather than a cost-based approach, especially in countries that reimburse disease management costs. The advantages of using personalized therapies are manifold: targeted patient population; avoidance of drug-related toxicities and optimization of costs in nonresponder patients; reduction in drug development costs, and fewer patients to be tested in clinical trials. The success of personalized therapy in future will depend on a better understanding of pharmacogenomics and the extension of these scientific advances to all countries.

摘要

个性化医疗有彻底改变患者护理的潜力。这种治疗方式根据药物遗传学和药物基因组学信息为个体患者开具特定的治疗方案。人类基因组图谱绘制是理解个体对治疗反应差异方面的一个重要里程碑。这些差异归因于基因型差异以及随之而来的表型表达。需要注意的是,理想情况下,靶向治疗应伴有诊断标志物。然而,目前大多数努力是分别针对这两者进行的;前者由制药公司开展,后者由诊断公司开展。此外,只有当所检测的生物标志物基于价值而非成本的方法进行区分时,这种配套策略才会成功,尤其是在那些报销疾病管理费用的国家。使用个性化疗法的优点是多方面的:针对特定患者群体;避免药物相关毒性并优化无反应患者的成本;降低药物研发成本,以及减少临床试验中需要测试的患者数量。未来个性化治疗的成功将取决于对药物基因组学的更好理解以及将这些科学进展推广到所有国家。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a72/3043364/a75bb24e8a66/PCR-1-146-g001.jpg

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