Hollingsworth Simon J
AstraZeneca, Innovative Medicines & Early Development - Oncology, Unit 310 - Darwin Building, Cambridge Science Park, Milton Road, Cambridge CB4 0FZ, UK.
Drug Discov Today. 2015 Dec;20(12):1455-63. doi: 10.1016/j.drudis.2015.10.005. Epub 2015 Oct 19.
A rapid expansion in precision medicine founded on the potential for durable clinical benefit through matching a drug to a predictive marker used to select patients has driven the development of targeted drugs with accompanied companion diagnostics for patient selection. Oncology has been at the forefront, with the improvements in patient survival notable. Increasing numbers of molecular subgroups require an equally increasing number (and new generation) of highly selective agents targeting inevitably lower incidence molecular segments, posing significant challenges for drug development. Innovative trial designs (umbrella or basket studies) are emerging as patient-centric approaches and public-private partnerships, cross-industry, government and non-profit sector collaborations are enabling implementation. Success will require continued innovation, new paradigms in oncology drug development and market approval and continued collaboration.
精准医学的迅速发展基于通过将药物与用于选择患者的预测标志物相匹配来实现持久临床获益的潜力,这推动了具有配套伴随诊断以进行患者选择的靶向药物的开发。肿瘤学一直处于前沿,患者生存率有显著提高。越来越多的分子亚组需要数量同样不断增加(以及新一代)的高度选择性药物,这些药物不可避免地针对发病率较低的分子片段,给药物开发带来了重大挑战。创新的试验设计(伞形或篮子研究)正在作为以患者为中心的方法出现,公私合作、跨行业、政府和非营利部门的合作正在推动其实施。成功将需要持续创新、肿瘤学药物开发和市场批准的新范式以及持续合作。