Adeniji Adeoluwa Akeem, Dulal Soniya, Martin Mike G
Oncology and Radiotherapy Department, Lagos University Teaching Hospital, Lagos, Nigeria.
National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal.
World J Oncol. 2021 Jun;12(2-3):50-60. doi: 10.14740/wjon1345. Epub 2021 May 14.
Personalized medicine (PM) has revolutionized oncology management in high human development indexed countries. By interrogating both disease and host factors through a variety of tools, oncologists have been able to better target an individual's cancer, leading to improved outcomes. But both the tools used to define these variables, such as next generation sequencing, large immunohistochemical and fluorescence hybridization (FISH) panels, and the weapons employed against each target are extremely expensive. The expenses have to be measured as not only the direct cost to the patient but also the cost to the system to develop and deploy the necessary infrastructure to optimally use them. However, the concepts of predictive, timely prevention and PM have demonstrated improvement in patient's satisfaction and cost effectiveness. In this paper we will summarize the relevant barriers and challenges that limit the implementation of PM in the developing world with an emphasis on the challenges in Nigeria and Nepal.
个性化医疗（PM）已经彻底改变了高人类发展指数国家的肿瘤学管理模式。通过使用各种工具来探究疾病和宿主因素，肿瘤学家能够更好地针对个体的癌症进行治疗，从而改善治疗效果。但是，用于定义这些变量的工具，如下一代测序、大型免疫组织化学和荧光原位杂交（FISH）检测板，以及针对每个靶点所使用的手段都极其昂贵。这些费用不仅要衡量为患者带来的直接成本，还要衡量为开发和部署必要基础设施以优化使用这些工具而给系统带来的成本。然而，预测性、及时预防和个性化医疗的理念已经证明能够提高患者满意度并提升成本效益。在本文中，我们将总结限制个性化医疗在发展中世界实施的相关障碍和挑战，重点关注尼日利亚和尼泊尔所面临的挑战。
