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Silva L, Pacheco T, Araújo E, Duarte RJ, Ribeiro-Vaz I, Ferreira-da-Silva R. Unveiling the future: precision pharmacovigilance in the era of personalized medicine. Int J Clin Pharm 2024; 46:755-760. [PMID: 38416349 PMCID: PMC11133017 DOI: 10.1007/s11096-024-01709-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/30/2024] [Indexed: 02/29/2024]
Abstract
In the era of personalized medicine, pharmacovigilance faces new challenges and opportunities, demanding a shift from traditional approaches. This article delves into the evolving landscape of drug safety monitoring in the context of personalized treatments. We aim to provide a succinct reflection on the intersection of tailored therapeutic strategies and vigilant pharmacovigilance practices. We discuss the integration of pharmacogenetics in enhancing drug safety, illustrating how genetic profiling aids in predicting drug responses and adverse reactions. Emphasizing the importance of phase IV-post-marketing surveillance, we explore the limitations of pre-marketing trials and the necessity for a comprehensive approach to drug safety. The article discusses the pivotal role of pharmacogenetics in pre-exposure risk management and the redefinition of pharmacoepidemiological methods for post-exposure surveillance. We highlight the significance of integrating patient-specific genetic profiles in creating personalized medication leaflets and the use of advanced computational methods in data analysis. Additionally, we examine the ethical, privacy, and data security challenges inherent in precision medicine, emphasizing their implications for patient consent and data management.
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Affiliation(s)
- Lurdes Silva
- Faculty of Pharmacy of the University of Porto, Porto, Portugal
| | - Teresa Pacheco
- Faculty of Pharmacy of the University of Porto, Porto, Portugal
| | - Emília Araújo
- Palliative Care Service, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
- Center for Health Technology and Services Research, Associate Laboratory RISE - Health Research Network (CINTESIS@RISE), Porto, Portugal
| | | | - Inês Ribeiro-Vaz
- Center for Health Technology and Services Research, Associate Laboratory RISE - Health Research Network (CINTESIS@RISE), Porto, Portugal
- Porto Pharmacovigilance Centre, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Community Medicine, Health Information and Decision, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Renato Ferreira-da-Silva
- Center for Health Technology and Services Research, Associate Laboratory RISE - Health Research Network (CINTESIS@RISE), Porto, Portugal.
- Porto Pharmacovigilance Centre, Faculty of Medicine of the University of Porto, Porto, Portugal.
- Department of Community Medicine, Health Information and Decision, Faculty of Medicine of the University of Porto, Porto, Portugal.
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Feng L, Yang W, Ding M, Hou L, Gragnoli C, Griffin C, Wu R. A personalized pharmaco-epistatic network model of precision medicine. Drug Discov Today 2023; 28:103608. [PMID: 37149282 DOI: 10.1016/j.drudis.2023.103608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/12/2023] [Accepted: 04/28/2023] [Indexed: 05/08/2023]
Abstract
Precision medicine, the utilization of targeted treatments to address an individual's disease, relies on knowledge about the genetic cause of that individual's drug response. Here, we present a functional graph (FunGraph) theory to chart comprehensive pharmacogenetic architecture for each and every patient. FunGraph is the combination of functional mapping - a dynamic model for genetic mapping and evolutionary game theory guiding interactive strategies. It coalesces all pharmacogenetic factors into multilayer and multiplex networks that fully capture bidirectional, signed and weighted epistasis. It can visualize and interrogate how epistasis moves in the cell and how this movement leads to patient- and context-specific genetic architecture in response to organismic physiology. We discuss the future implementation of FunGraph to achieve precision medicine. Teaser: We present a functional graph (FunGraph) theory to draw a complete picture of pharmacogenetic architecture underlying interindividual variability in drug response. FunGraph can characterize how each gene acts and interacts with every other gene to mediate therapeutic response.
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Affiliation(s)
- Li Feng
- Center for Computational Biology, College of Biological Sciences and Technology, Beijing Forestry University, Beijing 100083, China
| | - Wuyue Yang
- Beijing Yanqi Lake Institute of Mathematical Sciences and Applications, Beijing 101408, China
| | - Mengdong Ding
- Center for Computational Biology, College of Biological Sciences and Technology, Beijing Forestry University, Beijing 100083, China
| | - Luke Hou
- Ward Melville High School, East Setauket, NY 11733, USA
| | - Claudia Gragnoli
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA; Molecular Biology Laboratory, Bios Biotech Multi-Diagnostic Health Center, Rome 00197, Italy
| | - Christipher Griffin
- Applied Research Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
| | - Rongling Wu
- Center for Computational Biology, College of Biological Sciences and Technology, Beijing Forestry University, Beijing 100083, China; Beijing Yanqi Lake Institute of Mathematical Sciences and Applications, Beijing 101408, China; Yau Mathematical Sciences Center, Tsinghua University, Beijing 100084, China.
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Yu Z, Wang K, Wan Z, Xie S, Lv Z. Popular deep learning algorithms for disease prediction: a review. CLUSTER COMPUTING 2022; 26:1231-1251. [PMID: 36120180 PMCID: PMC9469816 DOI: 10.1007/s10586-022-03707-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/07/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Due to its automatic feature learning ability and high performance, deep learning has gradually become the mainstream of artificial intelligence in recent years, playing a role in many fields. Especially in the medical field, the accuracy rate of deep learning even exceeds that of doctors. This paper introduces several deep learning algorithms: Artificial Neural Network (NN), FM-Deep Learning, Convolutional NN and Recurrent NN, and expounds their theory, development history and applications in disease prediction; we analyze the defects in the current disease prediction field and give some current solutions; our paper expounds the two major trends in the future disease prediction and medical field-integrating Digital Twins and promoting precision medicine. This study can better inspire relevant researchers, so that they can use this article to understand related disease prediction algorithms and then make better related research.
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Affiliation(s)
- Zengchen Yu
- College of Computer Science and Technology, Qingdao University, Ningxia Road, Qingdao, 266071 China
| | - Ke Wang
- Psychiatric Department, Qingdao Municipal Hospital, Zhuhai Road, Qingdao, 266071 China
| | - Zhibo Wan
- College of Computer Science and Technology, Qingdao University, Ningxia Road, Qingdao, 266071 China
| | - Shuxuan Xie
- College of Computer Science and Technology, Qingdao University, Ningxia Road, Qingdao, 266071 China
| | - Zhihan Lv
- Department of Game Design, Faculty of Arts, Uppsala University, 75105 Uppsala, Sweden
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4
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Stakeholders Perceptions of Barriers to Precision Medicine Adoption in the United States. J Pers Med 2022; 12:jpm12071025. [PMID: 35887521 PMCID: PMC9316935 DOI: 10.3390/jpm12071025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022] Open
Abstract
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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Hartl D, de Luca V, Kostikova A, Laramie J, Kennedy S, Ferrero E, Siegel R, Fink M, Ahmed S, Millholland J, Schuhmacher A, Hinder M, Piali L, Roth A. Translational precision medicine: an industry perspective. J Transl Med 2021; 19:245. [PMID: 34090480 PMCID: PMC8179706 DOI: 10.1186/s12967-021-02910-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/25/2021] [Indexed: 02/08/2023] Open
Abstract
In the era of precision medicine, digital technologies and artificial intelligence, drug discovery and development face unprecedented opportunities for product and business model innovation, fundamentally changing the traditional approach of how drugs are discovered, developed and marketed. Critical to this transformation is the adoption of new technologies in the drug development process, catalyzing the transition from serendipity-driven to data-driven medicine. This paradigm shift comes with a need for both translation and precision, leading to a modern Translational Precision Medicine approach to drug discovery and development. Key components of Translational Precision Medicine are multi-omics profiling, digital biomarkers, model-based data integration, artificial intelligence, biomarker-guided trial designs and patient-centric companion diagnostics. In this review, we summarize and critically discuss the potential and challenges of Translational Precision Medicine from a cross-industry perspective.
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Affiliation(s)
- Dominik Hartl
- Novartis Institutes for BioMedical Research, Basel, Switzerland.
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany.
| | - Valeria de Luca
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Anna Kostikova
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Jason Laramie
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - Scott Kennedy
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - Enrico Ferrero
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Richard Siegel
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Martin Fink
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | | | | | - Markus Hinder
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Luca Piali
- Roche Innovation Center Basel, Basel, Switzerland
| | - Adrian Roth
- Roche Innovation Center Basel, Basel, Switzerland
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The European Union and personalised cancer medicine. Eur J Cancer 2021; 150:95-98. [PMID: 33892410 DOI: 10.1016/j.ejca.2021.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/20/2022]
Abstract
Two recent policy documents by the European Union, 'Europe's Beating Cancer Plan' and its accompanying 'Conquering Cancer: Mission Possible' (CCMP), articulate broad policies aimed at reducing cancer mortality across Europe, for example, by promoting prevention and early detection. The focus for cancer treatment in these manifestos is the expansion of personalised cancer medicine (PCM). However, the CCMP document suggests that the uptake of PCM is "hampered by uncertainty about its outcomes". What are these outcomes and why this uncertainty? We address the limits of PCM in pathology-driven and pathology-agnostic PCM, briefly discussing the results of umbrella and basket trials. We suggest that the complexity, plasticity and genetic heterogeneity of advanced cancers will continue to thwart the impact of PCM, limiting it to specific pathologies, or rare subsets of them. Caution regarding the advancement of PCM is justified, and policymakers should be wary of the hype of lobbyists, who do not acknowledge the limits of PCM.
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Patient-derived organoids as a predictive biomarker for treatment response in cancer patients. NPJ Precis Oncol 2021; 5:30. [PMID: 33846504 PMCID: PMC8042051 DOI: 10.1038/s41698-021-00168-1] [Citation(s) in RCA: 111] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/10/2021] [Indexed: 02/01/2023] Open
Abstract
Effective predictive biomarkers are needed to enable personalized medicine and increase treatment efficacy and survival for cancer patients, thereby reducing toxic side effects and treatment costs. Patient-derived organoids (PDOs) enable individualized tumour response testing. Since 2018, 17 publications have examined PDOs as a potential predictive biomarker in the treatment of cancer patients. We review and provide a pooled analysis of the results regarding the use of PDOs in individualized tumour response testing, focusing on evidence for analytical validity, clinical validity and clinical utility. We identify future perspectives to accelerate the implementation of PDOs as a predictive biomarker in the treatment of cancer patients.
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Issa AM, Carleton B, Gerhard T, Filipski KK, Freedman AN, Kimmel S, Liu G, Longo C, Maitland-van der Zee AH, Sansbury L, Zhou W, Bartlett G. Pharmacoepidemiology: A time for a new multidisciplinary approach to precision medicine. Pharmacoepidemiol Drug Saf 2021; 30:985-992. [PMID: 33715268 DOI: 10.1002/pds.5226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 03/09/2021] [Indexed: 11/06/2022]
Abstract
The advent of the genomic age has created a rapid increase in complexity for the development and selection of drug treatments. A key component of precision medicine is the use of genetic information to improve therapeutic effectiveness of drugs and prevent potential adverse drug reactions. Pharmacoepidemiology, as a field, uses observational methods to evaluate the safety and effectiveness of drug treatments in populations. Pharmacoepidemiology by virtue of its focus, tradition, and research orientation can provide appropriate study designs and analysis methods for precision medicine. The objective of this manuscript is to demonstrate how pharmacoepidemiology can impact and shape precision medicine and serve as a reference for pharmacoepidemiologists interested in contributing to the science of precision medicine. This paper depicts the state of the science with respect to the need for pharmacoepidemiology and pharmacoepidemiological methods, tools and approaches for precision medicine; the need for and how pharmacoepidemiologists use their skills to engage with the precision medicine community; and recommendations for moving the science of precision medicine pharmacoepidemiology forward. We propose a new integrated multidisciplinary approach dedicated to the emerging science of precision medicine pharmacoepidemiology.
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Affiliation(s)
- Amalia M Issa
- Personalized Precision Medicine & Targeted Therapeutics, Springfield, Pennsylvania, USA.,'Pharmaceutical Sciences' and 'Health Policy', University of the Sciences in Philadelphia, Philadelphia, Pennsylvania, USA.,'Family Medicine' and `Centre of Genomics & Policy'; Faculty of Medicine & Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Bruce Carleton
- Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, University of British Columbia, and BC Children's Hospital and Research Institute, Vancouver, British Columbia, Canada
| | - Tobias Gerhard
- Center for Pharmacoepidemiology and Treatment Science, Rutgers University, New Brunswick, New Jersey, USA
| | - Kelly K Filipski
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Andrew N Freedman
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Stephen Kimmel
- 'College of Public Health & Health Professions' and 'College of Medicine', University of Florida, Gainesville, Florida, USA
| | - Geoffrey Liu
- Epidemiology; Dalla Lana School of Public Health, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada
| | - Cristina Longo
- Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anke H Maitland-van der Zee
- Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Leah Sansbury
- Epidemiology, Value Evidence and Outcomes, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | - Wei Zhou
- Center for Observational and Real-world Evidence, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Gillian Bartlett
- School of Medicine, University of Missouri, Columbia, Missouri, USA
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Paran Y, Liron Y, Batsir S, Mabjeesh N, Geiger B, Kam Z. Multi-parametric characterization of drug effects on cells. F1000Res 2021; 9. [PMID: 33363713 PMCID: PMC7737707 DOI: 10.12688/f1000research.26254.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 12/28/2022] Open
Abstract
We present here a novel multi-parametric approach for the characterization of multiple cellular features, using images acquired by high-throughput and high-definition light microscopy. We specifically used this approach for deep and unbiased analysis of the effects of a drug library on five cultured cell lines. The presented method enables the acquisition and analysis of millions of images, of treated and control cells, followed by an automated identification of drugs inducing strong responses, evaluating the median effect concentrations and those cellular properties that are most highly affected by the drug. The tools described here provide standardized quantification of multiple attributes for systems level dissection of complex functions in normal and diseased cells, using multiple perturbations. Such analysis of cells, derived from pathological samples, may help in the diagnosis and follow-up of treatment in patients.
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Affiliation(s)
- Yael Paran
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot, 76100, Israel.,IDEA Biomedical Ltd., Rehovot, 76705, Israel
| | - Yuvalal Liron
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Sarit Batsir
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Nicola Mabjeesh
- Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, 64239, Israel
| | - Benjamin Geiger
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot, 76100, Israel.,Department of Immunology, The Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Zvi Kam
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot, 76100, Israel
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10
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Fader KA, Zhang J, Menetski JP, Thadhani RI, Antman EM, Friedman GS, Ramaiah SK, Vaidya VS. A Biomarker-Centric Approach to Drug Discovery and Development: Lessons Learned from the Coronavirus Disease 2019 Pandemic. J Pharmacol Exp Ther 2021; 376:12-20. [PMID: 33115823 PMCID: PMC11046728 DOI: 10.1124/jpet.120.000204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022] Open
Abstract
Faced with the health and economic consequences of the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the biomedical community came together to identify, diagnose, prevent, and treat the novel disease at breathtaking speeds. The field advanced from a publicly available viral genome to a commercialized globally scalable diagnostic biomarker test in less than 2 months, and first-in-human dosing with vaccines and repurposed antivirals followed shortly thereafter. This unprecedented efficiency was driven by three key factors: 1) international multistakeholder collaborations, 2) widespread data sharing, and 3) flexible regulatory standards tailored to meet the urgency of the situation. Learning from the remarkable success achieved during this public health crisis, we are proposing a biomarker-centric approach throughout the drug development pipeline. Although all therapeutic areas would benefit from end-to-end biomarker science, efforts should be prioritized to areas with the greatest unmet medical needs, including neurodegenerative diseases, chronic lower respiratory diseases, metabolic disorders, and malignant neoplasms. SIGNIFICANCE STATEMENT: Faced with the unprecedented threat of the severe acute respiratory syndrome coronavirus 2 pandemic, the biomedical community collaborated to develop a globally scalable diagnostic biomarker (viral DNA) that catalyzed therapeutic development at breathtaking speeds. Learning from this remarkable efficiency, we propose a multistakeholder biomarker-centric approach to drug development across therapeutic areas with unmet medical needs.
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Affiliation(s)
- Kelly A Fader
- Worldwide Research, Development and Medical, Pfizer Inc., Cambridge, Massachusetts (K.A.F., J.Z., G.S.F., S.K.R., V.S.V.); Foundation for the National Institutes of Health, Bethesda, Maryland (J.P.M.); Mass General Brigham, Boston, Massachusetts (R.I.T.); and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (E.M.A.)
| | - Jiangwei Zhang
- Worldwide Research, Development and Medical, Pfizer Inc., Cambridge, Massachusetts (K.A.F., J.Z., G.S.F., S.K.R., V.S.V.); Foundation for the National Institutes of Health, Bethesda, Maryland (J.P.M.); Mass General Brigham, Boston, Massachusetts (R.I.T.); and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (E.M.A.)
| | - Joseph P Menetski
- Worldwide Research, Development and Medical, Pfizer Inc., Cambridge, Massachusetts (K.A.F., J.Z., G.S.F., S.K.R., V.S.V.); Foundation for the National Institutes of Health, Bethesda, Maryland (J.P.M.); Mass General Brigham, Boston, Massachusetts (R.I.T.); and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (E.M.A.)
| | - Ravi I Thadhani
- Worldwide Research, Development and Medical, Pfizer Inc., Cambridge, Massachusetts (K.A.F., J.Z., G.S.F., S.K.R., V.S.V.); Foundation for the National Institutes of Health, Bethesda, Maryland (J.P.M.); Mass General Brigham, Boston, Massachusetts (R.I.T.); and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (E.M.A.)
| | - Elliott M Antman
- Worldwide Research, Development and Medical, Pfizer Inc., Cambridge, Massachusetts (K.A.F., J.Z., G.S.F., S.K.R., V.S.V.); Foundation for the National Institutes of Health, Bethesda, Maryland (J.P.M.); Mass General Brigham, Boston, Massachusetts (R.I.T.); and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (E.M.A.)
| | - Gary S Friedman
- Worldwide Research, Development and Medical, Pfizer Inc., Cambridge, Massachusetts (K.A.F., J.Z., G.S.F., S.K.R., V.S.V.); Foundation for the National Institutes of Health, Bethesda, Maryland (J.P.M.); Mass General Brigham, Boston, Massachusetts (R.I.T.); and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (E.M.A.)
| | - Shashi K Ramaiah
- Worldwide Research, Development and Medical, Pfizer Inc., Cambridge, Massachusetts (K.A.F., J.Z., G.S.F., S.K.R., V.S.V.); Foundation for the National Institutes of Health, Bethesda, Maryland (J.P.M.); Mass General Brigham, Boston, Massachusetts (R.I.T.); and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (E.M.A.)
| | - Vishal S Vaidya
- Worldwide Research, Development and Medical, Pfizer Inc., Cambridge, Massachusetts (K.A.F., J.Z., G.S.F., S.K.R., V.S.V.); Foundation for the National Institutes of Health, Bethesda, Maryland (J.P.M.); Mass General Brigham, Boston, Massachusetts (R.I.T.); and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (E.M.A.)
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11
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Sorigue M, Cañamero E, Sancho JM. Precision medicine in follicular lymphoma: Focus on predictive biomarkers. Hematol Oncol 2020; 38:625-639. [PMID: 32700331 DOI: 10.1002/hon.2781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023]
Abstract
Current care for patients with follicular lymphoma (FL) offers most of them long-term survival. Improving it further will require careful patient selection. This review focuses on predictive biomarkers (ie, those whose outcome correlations depend on the treatment strategy) in FL, because awareness of what patient subsets benefit most or least from each therapy will help in this task. The first part of this review aims to summarize what biomarkers are predictive in FL, the magnitude of the effect and the quality of the evidence. We find predictive biomarkers in the setting of (a) indication of active treatment, (b) front-line induction (use of anthracyline-based regimens, CHOP vs bendamustine, addition of rituximab), (c) post-(front-line)induction (rituximab maintenance, radioimmunotherapy), and (d) relapse (hematopoietic stem cell transplant) and targeted agents. The second part of this review discusses the challenges of precision medicine in FL, including (a) cost, (b) clinical relevance considerations, and (c) difficulties over the broad implementation of biomarkers. We then provide our view on what biomarkers may become used in the next few years. We conclude by underscoring the importance of assessing the potential predictiveness of available biomarkers to improve patient care but also that there is a long road ahead before reaching their broad implementation due to remaining scientific, technological, and economic hurdles.
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Affiliation(s)
- Marc Sorigue
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Eloi Cañamero
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
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12
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Beall RF, Hollis A. Global clinical trial mobilization for COVID-19: higher, faster, stronger. Drug Discov Today 2020; 25:1801-1806. [PMID: 32777537 PMCID: PMC7413203 DOI: 10.1016/j.drudis.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/10/2020] [Accepted: 08/03/2020] [Indexed: 12/29/2022]
Abstract
COVID-19 has prompted vastly more clinical trials than previous health emergencies. Trials started faster, are collectively larger, and are more diverse geographically. The initial trials so far are mostly not funded by industry. Lack of coordination will lead to inefficiency and duplication.
The clinical trial landscape for Coronavirus 2019 (COVID-19) is radically different from that of previous epidemics. Compared with H1N1, Ebola, and Zika, COVID-19 had an order of magnitude more clinical trials within the first 3 months following the declaration of a Public Health Emergency of International Concern (PHEIC). These trials have started much faster, are more geographically diverse, and are less likely to be funded by industry. However, the almost simultaneous design and initiation of hundreds of trials with 0.3 million participants across 78 countries creates the potential for congestion and inefficiencies and enhances risks for investors. Thus, an international coordination mechanism for clinical trials could be valuable in this and other situations.
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Affiliation(s)
- Reed F Beall
- Department of Community Health Sciences, Cumming School of Medicine and O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
| | - Aidan Hollis
- Department of Economics, University of Calgary, 527 Campus Place NW, Calgary, AB T2N 4Z6, Canada.
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