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个性化医学二十年:个体化药物治疗的过去、现在和未来。

Twenty Years with Personalized Medicine: Past, Present, and Future of Individualized Pharmacotherapy.

机构信息

Dx-Rx Institute, Fredensborg, Denmark

出版信息

Oncologist. 2019 Jul;24(7):e432-e440. doi: 10.1634/theoncologist.2019-0054. Epub 2019 Apr 2.

Abstract

On April 16, 1999, a short article appeared in entitled "New Era of Personalized Medicine: Targeting Drugs for Each Unique Genetic Profile," and here, the public was introduced to the term "personalized medicine" for the first time. A few months after publication of the article, it was reprinted in . The article describes the formation of the Single Nucleotide Polymorphisms Consortium, which was established as a collaboration between a number of major pharmaceutical companies and several academic research institutions, with support from the Wellcome Trust Foundation. Reading the article today, one will find that several of the important arguments for an individualized therapy are described in a similar way as we have known it from the past 20 years of discussion. The article mentioned the poor efficacy of the current pharmacotherapy, disease heterogeneity, and genetic variability, a showdown with the "one-size-fits-all" approach, and the use of predictive safety and efficacy biomarkers. Today, personal medicine is in competition with other terms such as "precision medicine" and "stratified medicine" and is no longer the preferred term for describing the individualized health care approach. Even though personalized medicine arose from the idea of improving and individualizing pharmacotherapy, the concept has influenced most other areas of our health care system. No matter if we use the term precision medicine or personalized medicine, the ideas that originated 20 years ago have greatly impacted the way we develop and implement new initiatives in relation to diagnosis, prevention, and treatment today. IMPLICATIONS FOR PRACTICE: Since the publication of the ideas behind personalized medicine in and 20 year ago, they have permeated medical research and innovation. This review will provide an overview of the background, definitions, and terminology and will describe some of the achievements in relation to the treatment of malignant diseases.

摘要

1999 年 4 月 16 日,一篇题为《个性化医学新纪元:针对每个独特基因谱的靶向药物》的短文出现在《新英格兰医学杂志》上,公众首次接触到“个性化医学”一词。该文发表几个月后,被转载于《柳叶刀》。文中描述了单核苷酸多态性联盟的形成,该联盟由多家大型制药公司与几家学术研究机构合作成立,得到了惠康信托基金会的支持。今天,当我们再次阅读这篇文章时,其中有几个重要的观点与我们过去 20 年来的讨论相似,例如个体化治疗的效果不佳、疾病异质性和遗传变异性、对“一刀切”方法的挑战以及使用预测安全性和疗效的生物标志物。如今,个性化医学与“精准医学”和“分层医学”等其他术语竞争,不再是描述个体化医疗方法的首选术语。尽管个性化医学源于改善和个体化药物治疗的理念,但该概念已影响到我们医疗保健系统的大多数其他领域。无论我们使用精准医学还是个性化医学的术语,20 年前提出的这些理念都极大地影响了我们今天在诊断、预防和治疗方面制定和实施新举措的方式。

实践意义

自 20 年前《新英格兰医学杂志》和《柳叶刀》发表个性化医学背后的理念以来,这些理念已经渗透到医学研究和创新中。本综述将概述其背景、定义和术语,并描述一些在恶性疾病治疗方面的成就。

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