Medicine of the future: personalized, stratified or precision? (literature review)

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“Personalized” medicine is based on the belief that each person has unique molecular, physiological, environmental and behavioral characteristics, and in case of development of the disease, each patient should be treated taking into account these unique characteristics. This belief was to some extent confirmed by the use of the latest technologies, such as DNA sequencing, proteomics, imaging protocols and the use of wireless devices for health monitoring, which revealed large inter-individual differences.

The purpose: to substantiate a personalized approach will be used in the medicine of the future.

Literary sources (scientific articles) were searched, including those published in peer-reviewed journals indexed in Pubmed, WoS, Scopus, Global Health, CyberLeninka, and the Russian Science Citation Index. Seventy two articles devoted to personalized medicine were analyzed, of which 51 are included in this review. The review included articles on personalized medicine, published mainly over the past 10 years on the topics of oncology, genetics, and articles considering the legal, demographic and social aspects of this problem. From the analysis were excluded articles devoted to the philosophical aspects of personalized medicine, the use of computer and wireless technologies for data processing and communication. Historical precedents, some legislative and policy aspects of its implementation in practice, new technologies that make it possible, some new experiences including successes and failures, ways of testing and using individualized drugs, and future directions, including potential ways of treating people with problems concerning fertility and infertility are considered. The existing limitations of “personalized” medicine are presented. Since aspects of “personalized” medicine are rooted in biological realities, individualization of medical practice in certain cases is probably inevitable.

Conclusion. With the development of technology and the accumulation of experience, an individual approach to the patient becomes more effective and cost-effective. In order for the various stakeholders to embrace “personalized” medicine and begin operating in this paradigm, it is necessary to develop and implement more effective strategies for the education and training of health professionals at all stages.

Contribution of the authors:
Dolgopolov I.S. — the concept and design of the study, writing the text, compiling a list of references;
Rykov M.Yu. — the concept and design of the study, writing the text, critical revision of the article with the introduction of valuable intellectual content.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: December 08, 2021
Accepted: January 19, 2022
Published: July 06, 2023 

 

Sobre autores

Igor Dоlgopolov

Tver State Medical University

Autor responsável pela correspondência
Email: noemail@neicon.ru
ORCID ID: 0000-0001-9777-1220
Rússia

Maksim Rykov

Russian State Social University; N.A. Semashko National Research Institute of Public Health

Email: wordex2006@rambler.ru
ORCID ID: 0000-0002-8398-7001

MD, PhD, DSci., Associate Professor, Head of the Department of Oncology, Hematology and Radiation Therapy of the Russian State Social University; Researcher, N.A. Semashko National Research Institute of Public Health, Moscow, 105064, Russian Federation.

e-mail: wordex2006@rambler.ru

Rússia

Bibliografia

  1. Erikainen S., Chan S. Contested futures: envisioning “Personalized,” “Stratified,” and “Precision” medicine. New Genet. Soc. 2019; 38(3): 308–30. https://doi.org/10.1080/14636778.2019.1637720
  2. Brown N., Rappert B., Webster A., eds. Contested Futures: A Sociology of Prospective Techno-Science. London: Ashgate; 2000.
  3. Shah G.L., Majhail N., Khera N., Giralt S. Value-based care in hematopoietic cell transplantation and cellular therapy: challenges and opportunities. Curr. Hematol. Malig. Rep. 2018; 13(2): 125–34. https://doi.org/10.1007/s11899-018-0444-z
  4. Davis P.B., Yasothan U., Kirkpatrick P. Ivacaftor. Nat. Rev. Drug Discov. 2012; 11(5): 349–50. https://doi.org/10.1038/nrd3723
  5. Gulland A. Cystic fibrosis drug is not cost effective, says NICE. BMJ. 2016; 353: i3409. https://doi.org/10.1136/bmj.i3409
  6. Check Hayden E. Promising gene therapies pose million-dollar conundrum. Nature. 2016; 534(7607): 305–6. https://doi.org/10.1038/534305a
  7. Pokorska-Bocci A., Stewart A., Sagoo G., Hall A., Kroese M., Burton H. «Personalized medicine»: what’s in a name? Per. Med. 2014; 11(2): 197–210. https://doi.org/10.2217/pme.13.107
  8. Council conclusions on personalised medicine for patients. OJEU. 2015; 58(C421): 2015C421/03:2-5.
  9. Nimmesgern E., Benediktsson I., Norstedt I. Personalized medicine in Europe. Clin. Transl. Sci. 2017; 10(2): 61–3. https://doi.org/10.1111/cts.12446
  10. Ginsburg G., Willard H. Genomics and personalized medicine: foundations and applications. Transl. Res. 2009; 154(6): 277–87.
  11. Nicholls S.G., Wilson B.J., Castle D., Etchegary H., Carroll C.J. Personalized medicine and genome-based treatments: why personalized medicine ≠ individualized treatments. Clin. Ethics. 2014; 9(4): 135–44.
  12. Schleidgen S., Klingler C., Bertram T., Rogowski W., Marckmann G. What is personalized medicine: sharpening a vague term based on a systematic literature. Review. BMC Med. Ethics. 2013: 14: 55. https://doi.org/10.1186/1472-6939-14-55
  13. Simmons L., Dinan M., Robison T., Snyderman R. Personalized medicine is more than genomic medicine: confusion over terminology impeded progress towards personalized healthcare. Per. Med. 2012; 9(1): 85–91. https://doi.org/10.2217/pme.11.86
  14. Heusser P. “Towards integration of ‘personalised’ and ‘person-centred’ medicine: the concept of ‘integrative and personalised health care’.” In: Vollman J., Sandow V., Wascher S., Schildmann J., eds. Ethics of Personalised Medicine: Critical Perspectives. London, New York: Routledge; 2015: 77–86.
  15. WHO. Priority medicines for Europe and the World 2013 update; 2013. Available at: http://www.who.int/medicines/areas/priority_medicines/MasterDocJune28_FINAL_Web.pdf
  16. AMS. Realising the potential of stratified medicine; 2013. Available at: https://acmedsci.ac.uk/viewFile/51e915f9f09fb.pdf
  17. Matthews P.M., Edison P., Geraghty O., Johnson M.R. The emerging agenda of stratified medicine in neurology. Nat. Rev. Neurol. 2014; 10(1): 15–26. https://doi.org/10.1038/nrneurol.2013.245
  18. Chan S., Erikainen S. What’s in a name? The politics of ‘precision medicine’. Am. J. Bioethics. 2018, 18(4): 50–2. https://doi.org/10.1080/15265161.2018.1431324
  19. Juengst E., McGowan M., Fishman J., Setterstein R. Jr. From ‘personalized’ to ‘precision’ medicine: the ethical and social implications of rhetorical reform in genomic medicine. Hastings Cent. Rep. 2016; 46(5): 21–33. https://doi.org/10.1002/hast.614
  20. Katsnelso A. Momentum grows to make ‘personalized’ medicine more ‘precise’. Nat. Med. 2013; 19(3): 249. https://doi.org/10.1038/nm0313-249
  21. Jameson L.J., Longo D.L. Precision medicine – personalized, problematic, and promising. Obstetric. Gynecol. Survey. 2015; 70(10): 612–4. https://doi.org/10.1097/01.ogx.0000472121.21647.38
  22. Garrod A.E. The Incidence of Alkaptonuria: A study of chemical individuality. Lancet. 1902; 160(4137): 1616–20.
  23. Mendel J.G. Versuche uber Pflanzenhybriden. In: Verhandlungen des naturforschenden Vereines in Brünn. Brno; 1865: 3–47.
  24. Fisher R.A. The correlation between relatives on the supposition of mendelian inheritance. Phil. Trans. R. Soc. Edinb. 1918; 52(2): 399–433.
  25. Carlsten C., Brauer M., Brinkman F., Brook J., Daley D., McNagny K., et al. Genes, the environment and personalized medicine: We need to harness both environmental and genetic data to maximize personal and population health. EMBO Rep. 2014; 15(7): 736–9. https://doi.org/10.15252/embr.201438480
  26. Schork N.J. Genetic parts to a preventive medicine whole. Genome Med. 2013; 5(6): 54. https://doi.org/10.1186/gm458
  27. Patel C.J., Sivadas A., Tabassum R., Preeprem T., Zhao J., Arafat D., et al. Whole genome sequencing in support of wellness and health maintenance. Genome Med. 2013; 5(6): 58. https://doi.org/10.1186/gm462
  28. Hogben L., Sim M. The self-controlled and self-recorded clinical trial for low-grade morbidity. Br. J. Prev. Soc. Med. 1953; 7(4): 163–79. https://doi.org/10.1136/jech.7.4.163
  29. Weber W.W. Pharmacogenetics. Oxford: Oxford University Press; 1997.
  30. Lee M.T., Klein T.E. Pharmacogenetics of warfarin: challenges and opportunities. J. Hum. Genet. 2013; 58(6): 334–8. https://doi.org/10.1038/jhg.2013.40
  31. Luzzatto L., Seneca E. G6PD deficiency: a classic example of pharmacogenetics with on-going clinical implications. Br. J. Haematol. 2014; 164(4): 469–80. https://doi.org/10.1111/bjh.12665
  32. O’Dwyer M.E., Druker B.J. Status of bcr-abl tyrosine kinase inhibitors in chronic myelogenous leukemia. Curr. Opin. Oncol. 2000; 12(6): 594–7. https://doi.org/10.1097/00001622-200011000-00013
  33. Etienne G., Dulucq S., Huguet F., Schmitt A., Lascaux A., Hayette S., et al. Incidence and outcome of BCR-ABL mutated chronic myeloid leukemia patients who failed to tyrosine kinase inhibitors. Cancer Med. 2019; 8(11): 5173–82. https://doi.org/10.1002/cam4.2410
  34. Gramegna A., Contarini M., Aliberti S., Casciaro R., Blasi F., Castellani C. From ivacaftor to triple combination: a systematic review of efficacy and safety of CFTR modulators in people with cystic fibrosis. Int. J. Mol. Sci. 2020; 21(16): 5882. https://doi.org/10.3390/ijms21165882
  35. Farkona S., Diamandis E.P., Blasutig I.M. Cancer immunotherapy: the beginning of the end of cancer? BMC Med. 2016; 14: 73. https://doi.org/10.1186/s12916-016-0623-5
  36. Gross G., Eshhar Z. Therapeutic potential of T cell chimeric antigen receptors (CARs) in cancer treatment: counteracting off-tumor toxicities for safe CAR-T cell therapy. Annu. Rev. Pharmacol. Toxicol. 2016; 56: 59–83. https://doi.org/10.1146/annurev-pharmtox-010814-124844
  37. Mohanty R., Chowdhury C.R., Arega S., Sen P., Ganguly P., Ganguly N. CAR T cell therapy: A new era for cancer treatment (Review). Oncol. Rep. 2019; 42(6): 2183–95. https://doi.org/10.3892/or.2019.7335
  38. Drescher C.W., Shah C., Thorpe J., O’Briant K., Anderson G.L., Berg C.D., et al. Longitudinal screening algorithm that incorporates change over time in CA125 levels identifies ovarian cancer earlier than a single-threshold rule. J. Clin. Oncol. 2013; 31(3): 387–92. https://doi.org/10.1200/jco.2012.43.6691
  39. Schork N.J., Goetz L.H. Single-subject studies in translational nutrition research. Annu. Rev. Nutr. 2017; 37: 395–422. https://doi.org/10.1146/annurev-nutr-071816-064717
  40. Liao X., Lochhead P., Nishihara R., Morikawa T., Kuchiba A., Yamauchi M., et al. Aspirin use, tumor PIK3CA mutation, and colorectal-cancer survival. N. Engl. J. Med. 2012; 367(17): 1596–606. https://doi.org/10.1056/nejmoa1207756
  41. Nan H., Hutter C.M., Lin Y., Jacobs E.J., Ulrich C.M., White E., et al. Association of aspirin and NSAID use with risk of colorectal cancer according to genetic variants. JAMA. 2015; 313(11): 1133–42. https://doi.org/10.1001/jama.2015.1815
  42. Jeon J., Du M., Schoen R.E., Hoffmeister M., Newcomb P.A., Berndt S.I., et al. Determining risk of colorectal cancer and starting age of screening based on lifestyle, environmental, and genetic factors. Gastroenterology. 2018; 154(8): 2152–64.e19. https://doi.org/10.1053/j.gastro.2018.02.021
  43. Rodriquez E., Domchek S.M. The prevention of hereditary breast cancer. Semin. Oncol. 2007; 34(5): 401–5. https://doi.org/10.1053/j.seminoncol.2007.07.006
  44. Kotsopoulos J., Huzarski T., Gronwald J., Singer C.F., Moller P., Lynch H.T., et al. Bilateral oophorectomy and breast cancer risk in BRCA1 and BRCA2 mutation carriers. J. Natl Cancer Inst. 2016; 109(1): djw177. https://doi.org/10.1093/jnci/djw177
  45. Rebbeck T.R., Friebel T., Lynch H.T., Neuhausen S.L., van ‘t Veer L., Garber J.E., et al. Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. J. Clin. Oncol. 2004; 22(6): 1055–62. https://doi.org/10.1200/jco.2004.04.188
  46. De Felice F., Marchetti C., Musella A., Palaia I., Perniola G., Musio D., et al. Bilateral risk-reduction mastectomy in BRCA1 and BRCA2 mutation carriers: a meta-analysis. Ann. Surg. Oncol. 2015; 22(9): 2876–80. https://doi.org/10.1245/s10434-015-4532-1

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