Precision Medicine in Oncology and Immuno-Oncology: Where We Stand and Where We're Headed

Abstract

Background/Aims: Precision medicine has only been a clinical reality only since the start of the 21st century, spurred on by the coevolution of science and technologies, as well as the increasing medical needs of aging societies of industrialized countries. Its overarching objective, from the perspective of the pharmaceutical and diagnostic industry, is to develop innovative therapeutic “concepts” with increased value for patients in a global health economy context. This article analyzes the recent advances and remaining challenges from a research, medical, and regulatory perspective in the development and introduction of precision medicine in oncology, more precisely in immuno-oncology. Methods: Analysis of the most recent scientific publications and clinical evidence. Results and Conclusion: Stakeholders need to combine efforts in order to turn scientific insights, such as those related to predictive biomarkers, into superior and affordable therapeutic concepts. Policymakers should also help to bring this about by ensuring that a suitable regulatory framework and incentive system are in place in order to encourage groundbreaking innovation, and hence the availability of new treatment options for patients.

Single-domain antibodies for targeting, detection andin vivoimaging of human CD4+cells

“…In precision medicine, diagnostic classification of the disease-associated immune status should guide the selection of appropriate therapies (1)(2)(3). A comprehensive analysis of a patient's specific immune cell composition, activation state, and infiltration of affected tissue has been shown to be highly informative for patient stratification.…”

“…In precision medicine, diagnostic classification of the disease-associated immune status should guide the selection of appropriate therapies. A comprehensive analysis of a patient's specific immune cell composition, activation state, and infiltration of affected tissue has been shown to be highly informative for patient stratification (Delhalle et al, 2018;Rossi et al, 2019;Scheuenpflug, 2017). CD4 + T cells are a key determinant of the immune status due to their essential role in orchestrating immune responses in autoimmune diseases, immune-mediated inflammatory diseases (IMIDs), cancer, and chronic viral infections (Aubert et al, 2011;Becker et al, 1990;Borst et al, 2018;Byrareddy et al, 2016;Chitnis, 2007;Di Mascio et al, 2009;Goverman, 2009;Penaloza-MacMaster et al, 2015).…”

Desafios atuais e futuros do uso da medicina de precisão no acesso ao diagnóstico e tratamento de câncer no Brasil

“…Essa nova forma de tratamento oncológico, ainda em processo de desenvolvimento e maturação de sua aplicação na clínica 24,30,31 , visa determinar a resposta terapêutica ideal por meio da classificação da população e dos tumores em agrupamentos biologicamente apropriados -uma abordagem estratificada que busca substituir os atuais protocolos que são aplicados de forma padronizada em toda a população 23 . Scheuenpflug 32 comenta que a medicina de precisão/personalizada, impulsionada pela evolução da ciência e das tecnologias do século XXI em um contexto de economia global da saúde, procura desenvolver conceitos inovadores e de maior valor terapêutico para pacientes das sociedades industrializadas e envelhecidas.…”

Single-Domain Antibodies for Targeting, Detection, and In Vivo Imaging of Human CD4+ Cells

“…In precision medicine, diagnostic classification of the disease-associated immune status should guide the selection of appropriate therapies. A comprehensive analysis of a patient's specific immune cell composition, activation state, and infiltration of affected tissue has been shown to be highly informative for patient stratification (1)(2)(3). In this context, CD4 is an important marker, as it is found on the surface of immune cells such as monocytes, macrophages, and dendritic cells and most abundant on CD4 + T cells (4,5).…”