肿瘤个体化医疗——路在何方?

How to fulfill the personalized medicine of cancer?

药能救人,也能杀人。同样的药对有的人安全有效,对有的人却无效,甚至会发生不良反应。药物反应的差别最终引起了医学史上的一场个体化医疗革命。研究表明,除了性别、年龄等因素外,遗传因素是引起药物反应差异的主要原因。基于现有化疗药物的肿瘤药物基因组学研究在各个领域正如火如荼地展开,通过仔细分析,发现这条路虽愿望良好,但过程曲折、代价昂贵、价值有限,而且是以瘤为本。那么肿瘤个体化医疗该如何实现呢?要实现肿瘤个体化医疗,药物研发不能再走以药为本和以瘤为本的路线,而是走以人为本的路线,即先应用药物基因组学从特定人群寻找药物设计靶标,再围绕靶标进行个体化药物研发,最后以特定人群为药物临床试验对象完成新药研发过程。

Same drug therapy may be safe and effective to some patients,but may be harmful to others. Difference of drug response finally causes the personalized medicine revolution in healthcare.The etiology of the difference of drug response is multifactorial,but is due in part to host genetic variations.Pharmacogenomic studies have successfully identified genetic variants that contribute to the variation in susceptibility to chemotherapy.We think study on personalized medicine based on now existed anticancer agents can not ultimately make the ideal of personalized medicine come true,since it is costly,complicated and has limited value.To fulfill the personalized medicine of cancer,we think more effort should be put on developing individual drugs with target specificity,and what pharmacogenomics can really help is to find new drug targets and select special groups for clinical trials,thus accelerating and simplifying the process of drug development.