Preventive, predictive, and personalized medicine for effective and affordable cancer care

Abstract

Preventive, predictive, and personalized medicine (PPPM) has created a wealth of new opportunities but added also new complexities and challenges. The European Cancer Prevention Organization already embraced unanimously molecular biology for primary and secondary prevention. The rapidly exploding genomic language and complexity of methods face oncologists with exponentially growing knowledge they need to assess and apply. Tissue specimen quality becomes one major concern. Some new innovative medicines cost beyond any reasonable threshold of financial support from patients, health care providers, and governments and risk sustainability for the health care system. In this review, we evaluate the path for genomic guidance to become the standard for diagnostics in cancer care and formulate potential solutions to simplify its implementation. Basically, introduction of molecular biology to guide therapeutic decisions can be facilitated through supporting the oncologist, the pathologist, the molecular laboratory, and the interventionist. Oncologists need to know the exact indication, utility, and limitations of each genomic service. Minimal requirements on the label must be addressed by the service provider. The interventionist is there to bring the most optimal tissue sample to pathology where the tissue is expanded to a variety of appropriate liquid-based samples. The large body of results then should be translated into meaningful clinical guidance for the individual patient. Surveillance, with the appropriate application of health economic indicators, can make this system long lasting. For governments and health care providers, optimal cancer care must result in a cost-effective, resource-sustainable, and patient-focused outcome.

Association among resistin, adenylate cyclase-associated protein 1 and high-density lipoprotein cholesterol in patients with colorectal cancer: a multi-marker approach, as a hallmark of innovative predictive, preventive, and personalized medicine

“…Namely, increased plasma resistin and plasma resistin/resistin mRNA ratio might be considered as easily detectable candidate markers of CRC development and progression. Thus, methods of molecular biology and genetic tests can complement and improve traditional biochemical determination of protein levels, as already postulated [38]. Additionally, this ratio can be easily determined in samples obtained by a simple venepuncture, which could present a significant advantage for potential clinical use.…”

Quantitative Analysis of Proteome in Non-functional Pituitary Adenomas: Clinical Relevance and Potential Benefits for the Patients

“…In addition, the hub molecules derived from PPI network of those overlapped molecules (DEGs; proteins) were obtained and verified in NFPAs, which confirmed the differences between NFPA and normal pituitary tissues. These proteomic and transcriptomic data were the important resource to screen out new tumor biomarkers to form a pattern biomarker for diagnosis and target treatments, which is emerging as a great promise for NFPAs (19,20) to achieve predictive, preventive, and personalized medicine (PPPM) for NFPA future research and clinical practice (70). These overlapped molecules are the important biomarker resource for sample stratification and clinical significance analysis (71).…”

Inappropriate modeling of chronic and complex disorders: How to reconsider the approach in the context of predictive, preventive and personalized medicine, and translational medicine

“…Hence, Jaak Janssens beautifully stated the question as: "should we speak about breast cancers instead of cancer?" [32,33].…”

“…Genomic guidance gradually becomes the standard for diagnostics in cancer care [33,34]. For example, in response to the growing knowledge about molecular characteristics of breast cancer subtypes and the need for personalized approach to the patients, the American Joint Committee on Cancer (AJCC) dramatically revised their latest edition (8th edition, last updated January 25, 2018) of breast cancer staging manual.…”

“…As stated by Janssens, "Should we speak about breast cancers instead of cancer?" [32,33]. Parallel to the personalized clinical approach, our disease models should be defined precisely.…”