Mao Jun J
Bendheim Integrative Medicine Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Med Acupunct. 2020 Dec 1;32(6):405-407. doi: 10.1089/acu.2020.1501. Epub 2020 Dec 16.
The Precision Medicine Initiative of 2015, together with a growing focus on patient-centered care, has challenged the U.S. health care system to provide the correct treatment to the correct individual patient rather than to a collective population. This demonstrates that acupuncture-with its history as an individualized therapy and with growing evidence-based clinical findings-is the ideal model for personalized medicine within oncology care. The current author and colleagues used previously conducted oncology acupuncture trials for pain, hot flashes, and insomnia to demonstrate that precise delivery of acupuncture might depend on a patient's genetics. Individual preferences and perceived evidence surrounding treatments might also factor into patient treatment choices. Further effectiveness evidence comparing acupuncture to drugs or cognitive-behavioral therapy provides insight on the relative benefit or harm of each treatment, which, in turn, can help clinicians and patients to choose the best treatment plans centered on patients' goals. To advance precision oncology acupuncture research, appropriate biomarkers and psychologic attributes should be incorporated into adequately powered and well-designed clinical trials to evaluate how acupuncture can be delivered to the correct patients.
2015年的精准医疗计划,再加上对以患者为中心的医疗越来越多的关注,促使美国医疗保健系统向正确的个体患者而非群体提供正确的治疗。这表明,针灸凭借其作为个体化疗法的历史以及越来越多基于证据的临床发现,是肿瘤护理中个性化医疗的理想模式。本文作者及其同事利用之前进行的针对疼痛、潮热和失眠的肿瘤针灸试验表明,精确的针灸治疗可能取决于患者的基因。个体偏好以及围绕治疗的感知证据也可能影响患者的治疗选择。将针灸与药物或认知行为疗法进行比较的进一步有效性证据,能让人了解每种治疗的相对益处或危害,进而有助于临床医生和患者选择以患者目标为中心的最佳治疗方案。为了推进精准肿瘤针灸研究,应将适当的生物标志物和心理特征纳入有足够样本量且设计良好的临床试验中,以评估如何将针灸应用于合适的患者。