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应用基因组信息管理进行新药研发与临床试验设计

New Drug Development and Clinical Trial Design by Applying Genomic Information Management.

作者信息

Ko Young Kyung, Gim Jeong-An

机构信息

Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul 08308, Korea.

Medical Science Research Center, College of Medicine, Korea University Guro Hospital, Seoul 08308, Korea.

出版信息

Pharmaceutics. 2022 Jul 24;14(8):1539. doi: 10.3390/pharmaceutics14081539.

Abstract

Depending on the patients' genotype, the same drug may have different efficacies or side effects. With the cost of genomic analysis decreasing and reliability of analysis methods improving, vast amount of genomic information has been made available. Several studies in pharmacology have been based on genomic information to select the optimal drug, determine the dose, predict efficacy, and prevent side effects. This paper reviews the tissue specificity and genomic information of cancer. If the tissue specificity of cancer is low, cancer is induced in various organs based on a single gene mutation. Basket trials can be performed for carcinomas with low tissue specificity, confirming the efficacy of one drug for a single gene mutation in various carcinomas. Conversely, if the tissue specificity of cancer is high, cancer is induced in only one organ based on a single gene mutation. An umbrella trial can be performed for carcinomas with a high tissue specificity. Some drugs are effective for patients with a specific genotype. A companion diagnostic strategy that prescribes a specific drug for patients selected with a specific genotype is also reviewed. Genomic information is used in pharmacometrics to identify the relationship among pharmacokinetics, pharmacodynamics, and biomarkers of disease treatment effects. Utilizing genomic information, sophisticated clinical trials can be designed that will be better suited to the patients of specific genotypes. Genomic information also provides prospects for innovative drug development. Through proper genomic information management, factors relating to drug response and effects can be determined by selecting the appropriate data for analysis and by understanding the structure of the data. Selecting pre-processing and appropriate machine-learning libraries for use as machine-learning input features is also necessary. Professional curation of the output result is also required. Personalized medicine can be realized using a genome-based customized clinical trial design.

摘要

根据患者的基因型,同一种药物可能会有不同的疗效或副作用。随着基因组分析成本的降低以及分析方法可靠性的提高,大量的基因组信息已可获取。药理学领域的多项研究已基于基因组信息来选择最佳药物、确定剂量、预测疗效以及预防副作用。本文综述了癌症的组织特异性和基因组信息。如果癌症的组织特异性较低,基于单个基因突变可在多个器官诱发癌症。对于组织特异性较低的癌症可开展篮子试验,确认一种药物对多种癌症中单个基因突变的疗效。相反,如果癌症的组织特异性较高,基于单个基因突变仅在一个器官诱发癌症。对于组织特异性较高的癌症可开展伞形试验。一些药物对具有特定基因型的患者有效。本文还综述了一种伴随诊断策略,即针对通过特定基因型选择出的患者开具特定药物。基因组信息用于药物计量学,以确定疾病治疗效果的药代动力学、药效学和生物标志物之间的关系。利用基因组信息,可以设计出更适合特定基因型患者的精密临床试验。基因组信息也为创新药物研发提供了前景。通过适当的基因组信息管理,可以通过选择合适的分析数据并理解数据结构来确定与药物反应和效果相关的因素。选择预处理方法和合适的机器学习库用作机器学习输入特征也是必要的。输出结果也需要专业的整理。使用基于基因组的定制临床试验设计可以实现个性化医疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec5f/9330622/708411873aad/pharmaceutics-14-01539-g001.jpg

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