Matus-Santos Juan Antonio, Aguilar-Ponce José Luis, Lara-Medina Fernando Ulises, Herrera-Gómez Ángel, Meneses-García Abelardo, López-Gamboa Mireya
Servicio de Oncología Médica, Instituto Nacional de Cancerología, Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2016 May-Jun;54(3):354-62.
Recent progress in medical knowledge has indicated that both clinical and biological markers will determine the response to different medical treatments: age, gender and genetics will determine the success of treatment. Genetic variability in this respect is fundamental and determines efficiency and safety of drugs, as well as susceptibility and illness' development. Fortunately, personalized medicine now offers individually tailored treatment strategies for each patient's needs. This is of outmost importance in oncology, since treatment is per se toxic and the commonly found low serum drug concentrations result in low treatment efficacy. Personalized medicine will allow a better approach to this, until now, a poorly managed disease. In this review we intent to raise awareness of personalized medicine and of clinical pharmacologic monitoring, with the aim to achieve adequate levels of efficacy and safety in the use of the cytotoxic drug 5-Fluorouracil (5-FU). Additionally, the importance of pharmacogenomics for the use of 5-FU is discussed. We designed this discussion towards medical practitioners challenged with treatment decisions every day, together with their patients.
医学知识的最新进展表明,临床和生物学标志物将决定对不同医学治疗的反应:年龄、性别和基因将决定治疗的成效。这方面的基因变异性至关重要,它决定了药物的疗效和安全性,以及易感性和疾病的发展。幸运的是,个性化医疗现在为每个患者的需求提供了量身定制的治疗策略。这在肿瘤学中至关重要,因为治疗本身具有毒性,而且常见的低血清药物浓度会导致低治疗效果。个性化医疗将有助于更好地应对这种迄今为止管理不善的疾病。在本综述中,我们旨在提高对个性化医疗和临床药理监测的认识,以在使用细胞毒性药物5-氟尿嘧啶(5-FU)时达到足够的疗效和安全水平。此外,还讨论了药物基因组学对5-FU使用的重要性。我们针对每天面临治疗决策的医生及其患者展开了此次讨论。