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Báo cáo y học: " Challenges in implementing individualized medicine illustrated by antimetabolite therapy of childhood acute lymphoblastic leukemia"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Challenges in implementing individualized medicine illustrated by antimetabolite therapy of childhood acute lymphoblastic leukemia. | Nersting et al. Clinical Proteomics 2011 8 8 http www.clinicalproteomicsjournal.eom content 8 1 8 CLINICAL PROTEOMICS REVIEW Open Access Challenges in implementing individualized medicine illustrated by antimetabolite therapy of childhood acute lymphoblastic leukemia Jacob Nersting1 Louise Borst1 and Kjeld Schmiegelow1 2 Correspondence kjeld. schmiegelow@rh.regionh.dk 1Pediatric Oncology Research Laboratory JMC-5704 Copenhagen University Hospital Rigshospitalet Blegdamsvej 9 DK-2100 Copenhagen Full list of author information is available at the end of the article 2 BioMed Central Abstract Predicting the response to medical therapy and subsequently individualizing the treatment to increase efficacy or reduce toxicity has been a longstanding clinical goal. Not least within oncology where many patients fail to be cured and others are treated to or beyond the limit of acceptable toxicity an individualized therapeutic approach is indicated. The mapping of the human genome and technological developments in DNA sequencing gene expression profiling and proteomics have raised the expectations for implementing genotype-phenotype data into the clinical decision process but also multiplied the complex interaction of genetic and other laboratory parameters that can be used for therapy adjustments. Thus with the advances in the laboratory techniques post laboratory issues have become major obstacles for treatment individualization. Many of these challenges have been illustrated by studies involving childhood acute lymphoblastic leukemia ALL where each patient may receive up to 13 different anticancer agents over a period of 2-3 years. The challenges include i addressing important but low-frequency outcomes ii difficulties in interpreting the impact of single drug or single gene response data that often vary across treatment protocols iii combining disease and host genomics with outcome variations and iv physicians reluctance in implementing potentially useful genotype and .