Precision Medicine in Cancer

Precision Medicine in Cancer

Nerethika Ravichandiran, Muneesh Kumar Barman, Sai Tejaswi Lavuri, Manjita Srivastava, Shalini Sakthivel, Meenakshi Singh, Kailash Chand, Subash C. Sonkar, Prudhvilal Bhukya
Copyright: © 2021 |Pages: 34
DOI: 10.4018/978-1-7998-6530-8.ch015
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Cancer is the one of the deadliest diseases and takes the lives of millions of people every year across the world. Due to disease heterogeneity and multi-factorial reasons, traditional treatment such as radiation therapy, immunotherapy, or chemotherapy are effective only among a small population of the patients. Tumors can have different fundamental genetic causes and protein expressions that differ from one patient to another. This variability among individual lends itself to the field of precision and personalized medicine. Following the completion of human genome sequencing, significant progress has been observed in the characterization of human epigenome, proteome, and metabolome. Pharmacogenetics and pharmacogenomics use this sequence to study the genetic causes of individual variations in drug response and the simultaneous impact of change in genome that decide the patient's response to drug respectively. On summation, identify the subpopulation of patient and provide them tailored therapy thus increasing the effectiveness of treatment. All these evolved the field of precision or personalized medicine that plays a crucial role in cancer prevention, prognosis, diagnosis, and therapeutics. These tailored therapies are characterized by increased efficiency and reduced toxicity. Not all cancers have genetic variability; some are also influenced by polymorphism of gene encoding enzymes that play an important role in pharmacokinetics of drug. The discoveries of cancer predisposition genes allow diagnosis of a patient at risk of cancer development and let them make the decision on précised individual risk modification characteristic. The use of CYP2D6 genotyping for breast cancer, mutation in KRAS in colorectal cancer, genomic variation in EGFR in small lung cancer, melanoma are some of the examples of importance of cancer predisposition genes. In recent times, distinct molecular subtypes of cancers have been identified with requirement of different treatment for each subtype. Precision medicine shifts the trend from reaction to prevention and forestalls disease progression.
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What Is Precision Or Personalized Medicine?

The center for disease defined personalized medicine as an approach for protecting and treating a disease that works on the basis of a person’s genome, environmental condition, and behaviors. The national research council explained that precision medicine can be explained as tailoring of medical treatment according to the individual characteristics of every patient. All these definitions direct towards a ‘person-centered approach’ (Maier et al.,2019). Thus precision translates to a person-centered approach. Precision medicine classifies individuals into subpopulations based on their difference in susceptibility to disease, diagnosis or prognosis of the disease, their response to specific treatments and minimizes the adverse effects due to drugs (Fig. 1).

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