Pregledni rad
Personalized medicine – where do we stand? Pouring some water into wine: a realistic perspective
Ursula Gundert-Remy
; Charité Universitätsmedizin Berlin, Institute for Clinical Pharmacology and Toxicology, Berlin, Germany
Aleksandar Dimovski
; Department of Biomolecular Sciences, Institute of Pharmaceutical Chemistry, Faculty of Pharmacy, University St. Cyril and Methodius, Skopje, Macedonia, F.Y.R.
Srećko Gajović
; University of Zagreb School of Medicine, Croatian Institute for Brain Research, Zagreb, Croatia
Sažetak
Abstract Reviewing the past and the present status of
personalized medicine, the hope and promise from several
years ago was critically compared to what is really achieved
to tailor the drug treatment according to the patient’s individuality.
The basis for consideration is what we know
about the variant of the disease the patient is suffering
from, and about the mechanisms influencing the plasma
concentration-time profile, such as activity of metabolizing
enzymes and transporters. In cancer treatment, drugs
are currently selected regarding molecular properties of
the cancer tissue, eg, expressing receptors such as HER2
receptor. Currently diagnostic tests are available allowing
to detect somatic cell mutations that can be used to guide
drug selection. Unfortunately, tumor heterogeneity and
developing resistance by further mutations may limit the
success of the therapy determined by molecular diagnostics.
The present status can be described that in drug kinetics
we know the influencing factors and we understand
the mechanisms. However, only in a few cases the genetic
background is the main determinant of kinetic variability,
and environmental and other factors have an additional
important role. Therefore, much more has to be done before
we can translate the accumulating knowledge into a
benefit for the patient. Only then, we can speak about personalized
medicine.
Ključne riječi
Hrčak ID:
85774
URI
Datum izdavanja:
15.8.2012.
Posjeta: 966 *