Personalized cancer therapy

McDermott U et al (2009) Personalized cancer therapy with selective kinase inhibitors an emerging paradigm in medical oncology. J Clin Oncol 27 5650-5659... 

We hope that the reader will find this book a useful guide to the molecular era of cancer biology and to the implications of increasing biology knowledge of personalized cancer therapy, particularly as it applies to the field of radiation oncology. 

Assessment of an individual patient s predisposition to drugs is essential to achieve the goal of personalized medicine in cancer therapy. Such an approach is needed for clinicians to decide which chemotherapeutic agents would be effective for a given patient and to avoid including ineffective agents (and the entailed side effects) in treatment options. 

Moreover gene-expression analysis of leukemia cells from B-lineage acute lymphoblastic leukemia pediatric patients has identified sets of differentially expressed genes that are associated specifically with sensitivity or resistance to chemotherapy. Such information can also be used in diagnostic assay to stratify the patients in sub-categories, to develop new drugs and later on to personalize the anti-cancer therapy. 

Krynetski EY, Evans WE. Pharmacogenetics of cancer therapy getting personal. Am J Hum Genet 1998 63 11 16. 

Important Note Statistical information about smallpox vaccine adverse reactions is ba.sed on data from two studies conducted in 1968. Adverse event rates in the United States today may be higher because there may be more people at risk from immune suppression (from cancer, cancer therapy, organ transplants, and illnesses such as HIV/AIDS) and eczema or atopic dermatitis. The outcome a.ssociated with adverse events may be less severe than previously reported because of advances in medical care. Rates may be lower for persons previously vaccinated. 

M. S. A. Palmnas and H. J. Vogel, The Future of NMR Metabolomics in Cancer Therapy Towards Personalizing Treatment and Developing Targeted Drugs , Metabolites, 2013, 3, 373. 

Patient databases with genetic profiles, e.g. for cardiovascular diseases, diabetes, cancer, etc. may play an important role in the future for individual health care, by integrating personal genetic profile into diagnosis, despite obvious ethical problems. The goal is to analyse a patient s individual genetic profile and compare it with a collection of reference profiles and other related information. This may improve individual diagnosis, prophylaxis, and therapy. 

Finally, therapeutic sequencing of different hormonal agents is fast becoming a common clinical practice, and fulvestrant is a good treatment choice to extend the opportunity for using endocrine therapies before reliance upon cytotoxic chemotherapy is necessary. Further research is required in order to evaluate the optimal sequence, both in clinical practice as well as in the laboratory, to choose the correct treatment of breast cancer in each person after the appearance of tamoxifen-induced drug resistance (Robertson 2004 Osipo et al. 2004 Johnston 2004 Robertson et al. 2005). 

---