Precision Oncology: a Clinical and Patient Perspective

Lassen, Ulrik; Makaroff, Lydia; Italiano, Antoîne; Vassal, Gilles; García‐Foncillas, Jesús; Avouac, Bernard

doi:10.2217/fon-2021-0688

Cited by 28 publications

(19 citation statements)

References 73 publications

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“…The concept of cancer immunosurveillance has evolved over time into the more recent cancer immunoediting theory. Activation of an innate and adoptive immune response that kills tumor cells (elimination phase), survival of sporadic tumor cells that trigger immunoediting (equilibrium phase), establishment of low-immunogenic tumors, and an immunosuppressive microenvironment (escape phase) are the three phases of cancer immunoediting [139][140][141]. Crosstalk between immune cells, cancer cells, and the microenvironment results in adaptive immune resistance, which is a normal process.…”

Section: Cancer Immunology and Cancer Immunotherapy Advancesmentioning

confidence: 99%

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Emerging Management Approach for the Adverse Events of Immunotherapy of Cancer

et al. 2022

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Immunotherapy, which stimulates the body’s immune system, has received a considerable amount of press in recent years because of its powerful benefits. Cancer immunotherapy has shown long-term results in patients with advanced disease that are not seen with traditional chemotherapy. Immune checkpoint inhibitors, cytokines like interleukin 2 (IL-2) and interferon-alpha (IFN), and the cancer vaccine sipuleucel-T have all been licensed and approved by the FDA for the treatment of various cancers. These immunotherapy treatments boost anticancer responses by stimulating the immune system. As a result, they have the potential to cause serious, even fatal, inflammatory and immune-related side effects in one or more organs. Immune checkpoint inhibitors (ICPIs) and chimeric antigen receptor (CAR) T-cell therapy are two immunotherapy treatments that are increasingly being used to treat cancer. Following their widespread usage in the clinic, a wave of immune-related adverse events (irAEs) impacting virtually every system has raised concerns about their unpredictability and randomness. Despite the fact that the majority of adverse effects are minimal and should be addressed with prudence, the risk of life-threatening complications exists. Although most adverse events are small and should be treated with caution, the risk of life-threatening toxicities should not be underestimated, especially given the subtle and unusual indications that make early detection even more difficult. Treatment for these issues is difficult and necessitates a multidisciplinary approach involving not only oncologists but also other internal medicine doctors to guarantee quick diagnosis and treatment. This study’s purpose is to give a fundamental overview of immunotherapy and cancer-related side effect management strategies.

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Section: Cancer Immunology and Cancer Immunotherapy Advancesmentioning

confidence: 99%

“…This review discusses immunotherapy and the pathways that lead to irAEs. To improve the efficacy of immunotherapy, we are concentrating on early detection methods and the management of a variety of toxicities, as well as improving the efficacy of toxicant-specific screening [120,137,139,140].…”

Section: Blockade Of Immune Checkpoints In Cancer Patientsmentioning

confidence: 99%

Emerging Management Approach for the Adverse Events of Immunotherapy of Cancer

et al. 2022

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“…The implementation of PM, especially biomarker testing, faces significant challenges. Some examples include practical limitations to PM utilization due to the adoption and implementation of novel biomarker testing and clinical decision support technologies and services, limited understanding of the clinical utility of biomarker tests to help guide patient management, and lack of consensus on levels of evidence necessary for the validation of particular biomarker tests as described by Lassen, et al [ 7 ]. However, these challenges are positioned as stakeholder specific and often limited to the clinicians and/or patients [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some examples include practical limitations to PM utilization due to the adoption and implementation of novel biomarker testing and clinical decision support technologies and services, limited understanding of the clinical utility of biomarker tests to help guide patient management, and lack of consensus on levels of evidence necessary for the validation of particular biomarker tests as described by Lassen, et al [ 7 ]. However, these challenges are positioned as stakeholder specific and often limited to the clinicians and/or patients [ 7 ]. Additional challenges to implementation include incorporating biomarker information into patient health records, delivering accessible and affordable PM technologies and services to patients, and ultimately contributing value for health care practitioners and payers [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The implementation of PM is difficult in the fragmented US health care system and many of the key stakeholders are often resistant to paradigm shifts in the standard of care [ 8 ]. Despite evidence that implementation of PM into daily health care delivery corresponds to benefits in patient care [ 9 ], there is work to be done in both the practices and policies that address the challenges at various levels of the healthcare system to fully integrate PM into the patient journey [ 7 ]. One of the overarching issues contributing to the relatively slow integration of PM for cancer care across all US healthcare systems is a lack of alignment on recognition of the challenges to PM implementation across key stakeholders, including payers and lab directors as well as clinicians and patients.…”

Section: Introductionmentioning

confidence: 99%

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Stakeholders Perceptions of Barriers to Precision Medicine Adoption in the United States

Schroll

Agarwal

Foroughi

et al. 2022

JPM

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Despite evidence that precision medicine (PM) results in improved patient care, the broad adoption and implementation has been challenging across the United States (US). To better understand the perceived barriers associated with PM adoption, a quantitative survey was conducted across five stakeholders including medical oncologists, surgeons, lab directors, payers, and patients. The results of the survey reveal that stakeholders are often not aligned on the perceived challenges with PM awareness, education and reimbursement, with there being stark contrast in viewpoints particularly between clinicians, payers, and patients. The output of this study aims to help raise the awareness that misalignment on the challenges to PM adoption is contributing to broader lack of implementation that ultimately impacts patients. With better understanding of stakeholder viewpoints, we can help alleviate the challenges by focusing on multi-disciplinary education and awareness to ultimately improve patient outcomes.

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Advancing precision medicine in medical education: Integrated, precise and data‐driven smart solutions

Papadopoulou

Lytras

2023

Applied Research

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Advances in “Precision Medicine” initiative, also known as “Personalized Medicine” is an emerging approach for disease treatment and prevention that has already led to innovative discoveries and has created “smart” applications and solutions tailored to a person's or a group of individuals' genetic profile, lifestyle, and environment interaction. Already many physicians as part of patient care routinely prescribe various molecular/genetic and other tests enabling them to select personalized treatments that improve the chances of survival and reduce exposure to adverse effects. This initiative should provide to medical and healthcare professionals with adequate resources and readily available solutions so that the target to specific treatments and care of the illnesses is achieved while at the same time protecting the privacy and safety of the individual is secured as well as the Electronic Health Records (EHRs) and whatever additional data is necessary within the context of Precision Medicine. This study, through a literature review mostly, and some case study analysis, examine whether personalized medicine is delivered to the patient in an “accurate” and “precise” way, as expected. This requires that Health and Human Services and other stakeholders and agencies collaborate to solicit the right input from patients while at the same time can identify and address any educational, practical, legal, and technical issues and providing smart solutions. The lack of proper medical education and advanced infrastructure are still major barriers to the adoption of Precision Medicine, therefore, the role of medical training in Precision Medicine is also examined and analyzed. Specific examples are discussed in an integrated, precise, and data‐driven manner to provide “smart” solutions.

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Precision Oncology: a Clinical and Patient Perspective

Cited by 28 publications

References 73 publications

Emerging Management Approach for the Adverse Events of Immunotherapy of Cancer

Emerging Management Approach for the Adverse Events of Immunotherapy of Cancer

Stakeholders Perceptions of Barriers to Precision Medicine Adoption in the United States

Advancing precision medicine in medical education: Integrated, precise and data‐driven smart solutions

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