Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain.
Office of Health Economics, London, UK.
Nat Med. 2022 Apr;28(4):658-665. doi: 10.1038/s41591-022-01717-2. Epub 2022 Apr 19.
With the increasing use of genomic profiling for diagnosis and therapy guidance in many tumor types, precision oncology is rapidly reshaping cancer care. However, the current trajectory of drug development in oncology results in a paradox: if patients cannot access advanced diagnostics, we may be developing drugs that will reach few patients. In this Perspective, we outline the major challenges to the implementation of precision oncology and discuss critical steps toward resolving these, including facilitation of equal access to genomics tests, ensuring that clinical studies provide robust evidence for new drugs and technologies, enabling physicians to interpret genomics data, and empowering patients toward shared decision-making. A multi-stakeholder approach to evidence generation, value assessment, and healthcare delivery is necessary to translate advances in precision oncology into benefits for patients with cancer globally.
随着基因组分析在许多肿瘤类型中的诊断和治疗指导中的应用越来越多,精准肿瘤学正在迅速重塑癌症治疗。然而,目前肿瘤学药物开发的轨迹导致了一个悖论:如果患者无法获得先进的诊断,我们可能正在开发的药物将很少能惠及患者。在本观点文章中,我们概述了实施精准肿瘤学所面临的主要挑战,并讨论了解决这些问题的关键步骤,包括促进基因组检测的平等获取、确保临床研究为新药和技术提供强有力的证据、使医生能够解读基因组数据,以及使患者能够共同参与决策。需要采取多利益相关者方法来生成证据、评估价值和提供医疗服务,以将精准肿瘤学的进展转化为全球癌症患者的获益。