What, in your view, is/are the best examples of the use of personalised medicine?
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- Answered 6 Jul 2019 Conflict of interest declaration: None This is a nice difficult question. Let´s meet here in 50 years... According to PubMed, there were roughly 1000 papers on "personalized medicine" ten years ago; that number increased ten times in 2018. The subject "cancer" reaches more than 22000 hits, all other specialties I checked (critical care, psychiatry, gynecology, dermatology,...) appear in less than 2000 papers. Does this mean that the best example are personalized treatments for cancer or just the main field of search or the more advanced? According to UpToDate "Potential benefits of personalized medicine include customized treatment plans" in every field, and "Analyses based upon gene expression profiling, proteomics, metabolomics, or lipidomics may enhance the predictive value of testing used for personalized medicine". The best is yet to come.
- Answered 7 Jul 2019 Conflict of interest declaration: None Interesting Q. I like this paper from 2012 "Personalized medicine" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3613206/), great section: "Herceptin (trastuzumab) used in breast cancer is directed to the 30% of breast cancers with an overexpression of HER-2 protein, which respond to Herceptin. Gleevec (Imatinib mesylate) is used to treat chronic myeloid leukemia, which has increased life expectancy from 5% to 95% at 5 years. Zelboraf (Vemurafenib) is used to treat melanoma, where the late-stage prognosis has been dismal, but 60% of patients have a defect in their DNA, and this drug benefits those with the V600E defect. Other successful personalized medicine examples of “treatment–biomarker” combinations are in colon cancer (Erbitux–EFGR) and lung cancer (Xalkori–ALK).1 There are also successful examples of the prediction of correct personalized dosing. The best known example is the CYP 450 enzyme and its application to Coumadin/warfarin therapy. The correct personalized dosing of warfarin could prevent 17,000 strokes in the United States and avoid 43,000 emergency room visits. The Mayo Clinic and Medco2 tested this prediction in 3,600 patients and found hospitalizations were reduced by 30%. However, in contrast to these successes, the personalized medicine approaches thus far in neurology have failed to replicate these successes."