Personalized medicine - where do we stand? Pouring some water into wine: a realistic perspective

Other - Discussion

• Author: Ursula Gundert-Remy
• Author: Aleksandar Dimovski
• Author: Srećko Gajović
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Reviewing the past and the present status of personalized medicine, the hope and promise from several years ago was critically compared to what is really achieved to tailor the drug treatment according to the patient's individuality. The basis for consideration is what we know about the variant of the disease the patient is suffering from, and about the mechanisms influencing the plasma concentration-time profile, such as activity of metabolizing enzymes and transporters. In cancer treatment, drugs are currently selected regarding molecular properties of the cancer tissue, eg, expressing receptors such as HER2 receptor. Currently diagnostic tests are available allowing to detect somatic cell mutations that can be used to guide drug selection. Unfortunately, tumor heterogeneity and developing resistance by further mutations may limit the success of the therapy determined by molecular diagnostics. The present status can be described that in drug kinetics we know the influencing factors and we understand the mechanisms. However, only in a few cases the genetic background is the main determinant of kinetic variability, and environmental and other factors have an additional important role. Therefore, much more has to be done before we can translate the accumulating knowledge into a benefit for the patient. Only then, we can speak about personalized medicine.

• Keywords (english): Biomarkers; Breast Neoplasms / drug therapy; Breast Neoplasms / genetics; Cardiovascular Diseases / drug therapy; Cardiovascular Diseases / genetics; Colorectal Neoplasms / drug therapy; Colorectal Neoplasms / genetics; Drug Approval; Genetic Testing; Genomics; Humans; Molecular Targeted Therapy; Pharmacogenetics; Pharmacokinetics; Precision Medicine / economics
• Language: english
• Publication type: Other - Discussion
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Croatian Medical Journal
• Numbering: vol. 53, no. 4, pp. 314-320
• p-ISSN: 0353-9504
• DOI: https://doi.org/10.3325/cmj.2012.53.314
• URN:NBN: urn:nbn:hr:105:201122
• Publication: 2012-08
• Document URL: http://www.cmj.hr/2012/53/4/22911523.htm
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-27 19:36:43