Research Paper: Revolution in Understanding Genetic Contributions

Pages: 4 (1343 words)  ·  Bibliography Sources: 3  ·  File: .docx  ·  Level: College Senior  ·  Topic: Medicine

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[. . .] One of the benefits of personalized care is that developers of new medications have been targeting new markers for different cancers and identifying specific patient populations that will respond to more targeted therapies. There has been a lot of excitement of the effectiveness of crizotinib for NSCLC even though a relatively small proportion of all NSCLC patients are likely to benefit.

The success and the fervor over crizotinib is warranted as it does appear to be promising in the treatment of some case of NSCLC and perhaps in several other cancers; however, it certainly is not a panacea. Of course one would not choose to use crizotinib in patients without the identified EML4-ALK fusion gene and its associated abnormal protein. In addition, in the Phase I/II studies it also appeared that some patients may have possessed a further mutation such that crizotinib was not effective for them. However, the real breakthrough here is the advancements in personalizing treatments. Personalized medicine is the real innovation here. In the past, health care and standards of care have always been based on epidemiological research performed on large patient cohorts. But as we are learning, the use of large cohorts does not consider the genetic variability in people. The development of drugs like crizotinib has the potential to lead to a paradigm shift in medicine. Using crizotinib as an example we can see how this paradigm shift might emerge. First, we have now recognized that perhaps certain conditions/diseases that share similar presentations are composed of a number of conditions with slightly different genetic alterations. By identifying the specific genetic variables in the diseases and the genetic variations that lead to resistance to treatment we can design specific treatments that can aid in the recovery of smaller cohorts of individuals. Over time, the identification of increasing different smaller cohorts of genetic variations in disease can lead to more and more personalized treatments for these cohorts. This relies on the systematic use of genetic or other personalized information to be able to select or optimize that patient's preventative and therapeutic care (Mehta, Jain, & Badve, 2011).

However, we need to remember that genetic tests are not perfect because many gene mutations are not perfect predictors of outcomes. However, once we know the genetic variables present in a clinical group we are able to specify and understand the specificity and sensitivity of the new diagnostics and we can better tailor the effectiveness of treatments. This information can lead to better success rates in treatment and the need for less guesswork.

Of course genetic variability would not be the only path that personalized medicine would follow. There are also molecular profiling technologies such as metabolomic analysis or proteomic profiling that can be useful. In addition all of these personalized methods could be useful to assess risk factors for a number of conditions and to tailor individual preventative measures for individuals at risk. The field of oncology appears to be ahead of other fields in personalized medicine, but the example that the development of medications like crizotinib have demonstrated indicates to this writer that there is a paradigm shift in medicine on the horizon.

References

Bang, Y., Kwak, E.L., Shaw, A.T. et al. (2010). Clinical activity of the oral ALK inhibitor PF- 02341066 in ALK-positive patients with nonsmall cell lung cancer (NSCLC). Journal of Clinical Oncology, 28 (18S), 3.

Christensen, J.G., Zou, H.Y., Arango, M.E., Li, Q., Lee, J.H., McDonnell, S.R., Yamazaki, S., Alton, G.R., Mroczkowski, B., & Los G. (2007). Cytoreductive antitumor activity of PF-2341066, a novel inhibitor of anaplastic lymphoma kinase and c-Met, in experimental models of anaplastic large-cell lymphoma. Molecular Cancer Therapy, 6, 3314-3322.

Ku, G.Y. & Lima Jopes Jr., G. (2011). EML4-ALK in non-small-cell lung cancer: the breathtaking progress from benchtop to Phase III clinical trial. Therapy, 8(1)55-61.

Kwak, E.L., Bang, Y.J., Camidge, D.R. et al. (2010). Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. New England Journal of Medicine, 263(18), 1693- 1703.

Mehta, R., Jain, R.K., &… [END OF PREVIEW]

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Revolution in Understanding Genetic Contributions.  (2011, June 12).  Retrieved December 7, 2019, from https://www.essaytown.com/subjects/paper/revolution-understanding-genetic-contributions/3869836

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"Revolution in Understanding Genetic Contributions."  12 June 2011.  Web.  7 December 2019. <https://www.essaytown.com/subjects/paper/revolution-understanding-genetic-contributions/3869836>.

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"Revolution in Understanding Genetic Contributions."  Essaytown.com.  June 12, 2011.  Accessed December 7, 2019.
https://www.essaytown.com/subjects/paper/revolution-understanding-genetic-contributions/3869836.