THE EFFECT OF RNAI-MEDIATED GENE SILENCING ON HER-2/NEU GENE EXPRESSION IN LUNG ADENOCARCINOMA CELLS

Objective: Her-2/neu protein overexpression has been demonstrated in Non-small cell lung cancer, especially in lung adenocarcinoma. Its overexpression often indicates a poor prognosis. Therapeutic agents against her-2/neu have been intensively sought over the past decades. The objective of this paper is to investigate the effect of chemically synthesized siRNA targeting her-2/neu on her-2/neu dysregulated human lung adenocarcinoma cells. Methods: Calu-3 cells were transfected with siRNAs formulated LipofectAMINE 2000. The her-2/neu mRNA and protein levels were detected by RT-PCR and flow cytometry (FCM). The biological morphology and growth inhibition of calu-3 cells were observed with light microscopy and MTT assay, respectively. The cell cycle and apoptosis rate were analyzed by FCM. Results: siRNA targeting Her-2/neu down-regulated the transcription of her-2/neu oncogene and protein level. Slowed cell proliferation and cell cycle arrest at G0/1 stage could be also observed, accompanied with enhanced cell apoptosis. Conclusion: Specific siRNA targeting her-2/neu can effectively inhibit her-2/neu expression in her-2/neu overexpressing calu-3 cell lines. siRNA-mediated gene silencing may be a useful therapeutic strategy for cancer.

Effects of Spinach Powder Fat-Soluble Extract on Proliferation of Human Gastric Adenocarcinoma Cells

Four kinds of assays were used to study the effect of a fat-soluble extract of spinach powder (SPFE) on the proliferation of human gastric adenocareinoma cell line (SGC-7901) in vitro.These studies included: (Ⅰ) cell growth assay, (Ⅱ) colony forming assay, (Ⅲ) MTT colorimetric assay, and (Ⅳ) 3H-TdR incorporation assay. The concentrations of SPFE expressed as the level of β-carotene in the medium were 2×10-8, 2×10-7 and 2×10-6 mol/L β-carotene in assays (Ⅰ)～(Ⅲ), but 4×10- 8, 4×10-7 and 4×10-6 mol/L β-caretene in assay (Ⅳ) respectively. The results indicated that SPFE inhibited the prolifendion and colony forming ability of SGC-7901 cells. And in MTT assay, SPFE inhibited the viability of SGC7901 cells, but no inhibitory effect of SPFE was observed on the viability of lymphocytes in peripheral blood of healthy people. Finally, in the 3H-TdR incorporation test, both SPFE and β-carotene showed significant inhibitory effects on DNA synthesis in SGC-7901 cells, but SPFE was more effective than β-carotene.

EXPERIMENTAL RESEARCH OF EFFECTIVENESS OF siRNA-Her-2/neu ON DRUG SENSITIVITY OF Her-2/neu-OVER-EXPRESSING LUNG ADENOCARCINOMA CELL LINE

Objective： Her-2/neu protein overexpression has been demonstrated in lung adenocarcinoma. Its overexpression often indicates a poor prognosis and resistance to chemotherapeutic agents. The objectives of this paper is to explore the effectiveness of double-stranded short inhibitory RNAs （siRNA） targeting Her-2/neu oncogene on the drug sensitivity of Her-2/neu-overexpressing lung adenocarcinoma cells. Methods： Lung adenocarcinoma cell line calu-3 was transfected with siRNAs formulated LipofectAMINE 2000, and Her-2/neu protein and P-gp were determined by flow cytometry （FCM）. The chemosensitivity of transfected cells to cisplatin （CDDP） was measured by MTT. Cell apoptosis detection kit （Annexin V method） was used to examine the drug induced apoptosis rate. Results： siRNA targeting Her-2/neu greatly reduced the cell surface expression of Her-2/neu protein and had no effect on P-gp. Consequently the inhibitory rate of CDDP in combination with siRNA targeting Her-2/neu was （67.1±2.3）%, while the inhibitory rates were （48.1±3.5）%, （46.3±5.9）% and （50.2±2.9）% in untreated control, empty vector and unrelated siRNA groups, respectively. The FCM results showed that the apoptosis rate of cells treated with CDDP combined with siRNAs-Her-2/neu was elevated when compared with unrelated siRNA group and empty vector group. Conclusion： Sequence specific siRNA targeting Her-2/neu was capable of enhancing the chemosensitivity of calu-3 cell to cisplatin.

EFFECT OF CIS-9, TRANS-11-CONJUGATED LINOLEIC ACID ON CELL CYCLE OF MAMMARY ADENOCARCINOMA CELLS(MCF-7)

Objective: To determine the effect of cis-9, trans-1 1-conjugated linoleic acid on the cell cycle of mammary cancer cells (MCF-7) and the possible mechanism of the inhibitory effect of c9,t11-CLA. Methods: Using cell culture and immunocytochemical techniques, we examined the cell growth, DNA synthesis, expression of PCNA, cyclin A, B1, D1, p16ink4a and p21cip/waf1 of MCF-7 cells at various c9,t11-CLA concentrations (25μM, 50μM, 100μM and 200μM), at 24h and 48h. 96% ethand was used as negative control. Results: The cell growth and DNA synthesis of MCF-7 cells were inhibited by c9,t11-CLA. After treatment with various doses of c9,t11-CLA mentioned above for 8 days, the inhibition frequency was 27.18%, 35.43%, 91.05%, and 92.86%, respectively. Inhibitory effect of c9,t11-CLA on DNA synthesis (except for 25μM, 24h) was demonstrated by significantly less incorporation of 3H-TdR than the negative control (P<0.05 and P<0.01). To further investigate the influence of the cell cycle progression, we found that c9,t11-CLA may arrest the cell cycle of MCF-7 cells. Immunocytochemical staining demonstrated that incubation with different concentration of c9,t11-CLA at various times significantly decreased the expression of PCNA, Cyclin A, B1, D1 in MCF-7 cells compared to the negative control (P<0.01), whereas the expression of p16ink4a and p21cip/waf1, cyclin-dependent kinases inhibitors (CDKI), were increased. Conclusions: The cell growth and proliferation of MCF-7 cells is inhibited by c9,t11-CLA via blocking cell cycle, accompanying reduced expression of cyclin A, B1, D1 and enhanced expression of CDKI (p16ink4a and p21cip/waf1).

Regulation Effect of miR-34a Expression on Radiosensitivity of Lung Adenocarcinoma Cells by Targeting Bcl-2 and CDK4/6 Signaling Pathways

Objective: Radiotherapy has been widely used to treat lung cancer. However, non-small lung cancer cells are insensitive to radiation, diminishing their radiotherapy effects. Although the radiosensitivity of the non-small lung cancer cells was reported to be enhanced through regulating miR-34a, the regulation effects of miR-34a expression on radiosensitivity of lung adenocarcinoma cells through target genes CDK4, CDK6, CyclinD1, and Bcl-2/Bax have not been systematically investigated. Methods: In this study, we investigated the effect of miR-34a expression on the Bcl-2, CDK4, and CDK6 pathways in lung adenocarcinoma cells, to provide new insights into the sensitization treatment of lung cancer. We first studied the effect of miR-34a expression on H1299 and A549 cell activity. Then to investigate the mechanisms of radiosensitivity, we focused on apoptosis, cell cycle, and target genes. Results: We find that overexpression of miR-34a in lung adenocarcinoma cells inhibits cell activity, and improves radiosensitivity. Specifically, overexpression of miR-34a suppresses the expression of target genes CDK4, CDK6, CyclinD1, and Bcl-2/Bax, which leads to cell cycle arrest and promotes apoptosis of lung adenocarcinoma cells. Conclusions: Overall, our results demonstrate that the overexpression of miR-34a enhances the radiosensitivity of lung adenocarcinoma cells, indicating that miR-34a is a sensitizer for lung adenocarcinoma radiotherapy.

CLONING AND IDENTIFICATION OF A GENE RELATED TO THE DIFFERENTIATION OF HUMAN GASTRIC ADENOCARCINOMA CELLS

Objective: To compare the differential expression of mRNA between MKN-28 (highly differentiated) and MKN-45 (poorly differentiated) gastric adenocarcinoma cells and identify genes involved in human gastric adenocarcinoma differentiation. Methods: Differential expression of mRNA between MKN-28 and MKN-45 adenocarcinoma cells was investigated by fluorescent differential display (FDD). Differentially expressed cDNA was analyzed by bioinformatics and confirmed by RT-PCR and Northern-blot. Results: 45 differential fragments were finally attained. One of them (No. 10) was an approximate 750 bp cDNA and highly up-regulated in MKN-45 cells as compared with MKN-28 cells. By using Blastn and UniGene database analysis, we found the fragment was mapped to chromosome 14q11.2–q12 and showed a significant homology to Bcl-2 binding protein gene (BNip3), which was recently identified encoding pro-apoptosis protein located in mitochondrial. Conclusion: The BNip3 induced apoptosis could be suppressed by interacting with bcl-2. The BNip3 gene in tumor cells might be up-regulated by the hypoxia response element through the HIF1a transcription factor, causing death of the hypoxic cells at the center of the tumor where vascularization is usually poor in the process of tumor development.

CHEMOSENSITIVITY OF MGc80-3 HUMAN GASTRIC ADENOCARCINOMA CELLS AND ITS CLINICAL SIGNIFICANCE

In the present study, the chemosensitivity of MGc80-3 human gastric adenocarcinoma cells was determined by means of colony-forming assay and the in vitro activities of 10 anticancer drugs were examined on the basis of the clinically achievable peak plasma drug concentration. The results showed that MGc80-3 cells were most sensitive to mitomyc'n C, adriamycin and 5-fluorouracil, being consistent with the response noted in clinical gastric cancer. This cell line may retain its original drug sensitivity and may be useful in screening for new compounds with activity against this disease.

Effects of tachyplesin and n-sodium butyrate on proliferation and gene expression of human gastric adenocarcinoma cell line BGC-823

瞄准：在增长和人的胃的腺癌房间线 BGC-823 的基因表示上调查 tachyplesin 和 n 钠丁酸盐的效果。方法：BGC-823 房间的增长上的 tachyplesin 和 n 钠丁酸盐的效果与尝试平底锅蓝色染料排除测试被决定并且他染色。房间周期上的 tachyplesin 和 n 钠丁酸盐的效果被流动血细胞计数检测。c-erbB-2， c-myc， p53 和 p16 的蛋白质层次被免疫细胞化学检验。结果：禁止的效果在 2.0 mg/L tachyplesin 和 2.0 mmol/L n 钠丁酸盐处理以后是类似的，细胞的生长的禁止的率分别地是 62.66% 和 60.19% ，并且各自的最大的有丝分裂的索引被 49.35% 和 51.69% 分别地减少。Tachyplesin 和 n 钠丁酸盐处理能显著地在 /G (1 ) 分阶段执行并且减少的 G (0 ) 增加房间的比例在 S 的比例阶段。当表示肿瘤铺平时， oncogene c-erbB-2， c-myc，和 mtp53 蛋白质的表示层次是下面调整的压制或基因 p16 蛋白质在有 tachyplesin 或 n 钠丁酸盐的处理以后是起来调整的。在有 1.0 mmol/L n 钠丁酸盐的联合的 1.0 mg/L tachyplesin 的效果比他们在改变房间周期分发和 c-erbB-2， c-myc， mtp53 和 p16 蛋白质的表示的单个处理显然优异。在联合处理以后的 BGC-823 房间的细胞的生长的禁止的率是 62.29% ，最大的有丝分裂的索引被 51.95% 减少。结论：肿瘤房间的区别 inducer 在肿瘤房间， oncogene 和肿瘤压制的关联词的表示或基因的增长上作为 n 钠丁酸盐有类似的效果的 Tachyplesin。它也在肿瘤房间的区别上有协同的效果。

Growth inhibitory effect of wild-type Kras2 gene on a colonic adenocarcinoma cell line

AIM: To observe the growth inhibitory effect of wild-type Kras2 gene on a colonic adenocarcinoma cell line Caco-2. METHODS: Recombinant plasmid pCI-neo-Kras2 with wild type Kras2 open reading frame was constructed. The Caco-2 cells were transfected with either pCI-neo or pCI-neo-Kras2 using Lipofectamine 2000. The expression of wild type Kras 2 was examined by Northern blot analysis. And the expression of wild type Kras2 protein was examined by Western blot analysis. The effects of wild-type Kras2 on cell proliferation were analyzed by monotetrazolium (MTT) assay, meanwhile analyses of cell cycle and spontaneous apoptosis rate were carried out by flow cytometry (FCM). RESULTS: The plasmid of pCI-neo-Kras 2 was successfully established. The growth rate of cells transfected with pCI-neo-Kras2 was significantly lower than the control cells transfected with the empty pCI-neo vector (P < 0.05). Cell cycle analysis revealed arrest of the pCI-neo-Kras2 transfected cells in G0/G1 phases, decreased DNA synthesis and decreased fractions of cells in S phase. The proliferative index of cells transfected with pCI-neo-Kras2 was decreased compared with the control cells (49.78% vs 64.21%),while the apoptotic rate of Caco-2 cells with stable Kras 2 expression increased (0.30% vs 0.02%). CONCLUSION: The wild-type Kras2 gene effectively inhibits the growth of the colonic adenocarcinoma cell line Caco-2.

Expression heterogeneity research of ITGB3 and BCL-2 in lung adenocarcinoma tissue and adenocarcinoma cell line

Objective:To analyze expression heterogeneity of Integrin beta 3(ITCB3) and B-cell lymphoma2(BCL-2) in lung adenocarcinoma tissue and adenocarcinoma cell line and further provide theoretical direction for molecular biological research of lung adenocarcinoma.Methods:Tissue microarray was used to observe relation among expression,heterogeneitpy and clinical characteristics of ITGB3 and BCL-2 in lung cancer.Results:ITGB3 and BCL-2 increased significantly in A549 cells in CAFs group with β-actin as control:the expression level of BCL-2also increased in 1TGB3 transfected cells with CFP plasmid transfected A549 cells as control:immunohistochemistry staining showed that positive ratcs of 1TGB3,ITGB1 and BCL-2 in normal lung tissues were 0.the positive rates in lung adenocarcinoma were 7.049%,84.51%and 4.23%,respectively:in the results of immunohistochemistrv staining,the expression of Girdin protein in lung adenocarcinoma was homogeneous,however protein expression of 1TCB3,ITGB1 and BCL—2showed different patterns in the same location with significant heterogeneity;majority of ITGB3,TTCB1 or BCL—2 positive tissue showed heterogeneity that expression in trailing edge was higher than that of trailing edge in lung adenocarcinoma tissue,the patients with BCL-2 heterogeneity showed higher lymph node metastasis ratio and lower clinical stage(P<0.05);and the expression of ITGB3 and the clinical characteristics of patients were not significant related(P>0.05).Conclusions:Expression of ITGB3 and BCL-2 in lung adenocarcinoma and adenocarcinoma cell line showed heterogeneity that expression in trailing edge was higher than that of trailing edge,which may play an important role in promoting tumor lymph node metastasis and vascular invasion,and provides a new research direction for exploration of lung adenocarcinoma metastasis mechanism.

Quantitative Analysis of DNA Content of Adenocarcinoma Cells in Effusion

DNA content of cells in effusion of 33 cases of mesothelial and adenocarcinomacells was measured by microspectrophotometer.The results showed that compared withmesothelial cells the DNA content of the suspected malignant cells was obviously increa-sed (P【0.01),the DNA content of both highly and poorly differentiate adenocarcinomacells was obviously increased and statistically significant difference existed between them(P【0.01);besides,aneuploidy could be found.It is objective,accurate and sensitive todetermine the character and differentiation degrees of adenocarcinoma cells in effusion byquantitaive analysis of DNA content with microspectrophotometer.

Effect of cis-9,trans-11-conjugated linoleic acid on cell cycle of gastric adenocarcinoma cell line(SGC-7901)

AIM: To determine the effect of cis-9, trans-1l-conjugated linoleic acid ( c9, tl 1-CLA) on the cell cycle of gastric cancer cells( SGC-7901 ) and its possible mechanism in inhibition cancer growth.METHODS: Using cell culture and immunocytochemicaltechniques, we examined the cell growth, DNA synthesis,expression of PCNA, cyclin A, B1, D1, pl6nink4a and p21clp/wafl ofSGC-7901 cells which were heated with various c9, tll-CLAconcentrations (25,50,100 and 200μnol@L-1)of c9, tll-CLA for 24and 48 h, with a negative control (0.1% ethane).RESULTS: The cell growth and DNA synthesis of SGC-7901cells were inhibited by c9, tll-CLA. SGC-7901 cells. Eightday after treatment with various concentrations of c9, tl1-CLA mentioned above, the inhibition rates were 5.92 % ,20.15 % ,75.61% and 82.44 % ,respectively and inhibitory effeotof c9, tll-CLA on DNA synthesis (except for 25 tmol/L,24h) showed significantly less 3H-TdR incorporation than thatin the negative controls (P ＜ 0. 05 and P ＜ 0. 01).Immunocytochemical staining demonstrated that SGC-7901cells preincubated in media supplemented with different c9,tl1-CLA concentrations at various times significantlydecreased the expressions of PCNA (the expression rateswere7.2-3.0 %,24 h and 9.1-0.9 % at 48 h, respectively),Cyclin A (l1.0-2.3 %, 24 h and 8.5-0.5 % ,48 h), B1 (4.8-1.8% at 24 h and 5.5-0.6 % at 48 h)and D1 (3.6-1.4 % at 24 hand 3.7 %-0 at 48 h) as compared with those in the negativecontrols(the expressions of PCNA, Cyclin A, B1 and D1were 6.5 % at 24h and 9.0 % at 48 h, 4.2% at 24h and5.1% at 48 h, 9.5 % at 24h and 6.0 % at 48 h,respectively)(P＜ 0.01), whereas the expressions of p16ink4a and p21clp/waf1,cyclin-dependent kinases inhibltors(CDKI), were increased.CONCLUSION: The cell growth and proliferation of SGC-7901cell is inhibited by c9, tll-CLA via blocking the cell cycle,with reduced expressions of cyclin A, B1 and D1 andenhanced expressions of CDKI( p16ink4a and p21cip/waf1).

The Effects of Cyclic Stretching on the Proliferation of Lung Adenocarcinoma Cells in Vitro

Using FX-4000 strain unit, the prolieration in human lung adenocarcinoma A549 cells that underwent mechanical strain of different waveform、frequency and duration were studied. Image analysis revealed that cellular proliferation rate(PR) reduced significantly after cells were subjected to square wave with 0～20% elongation at frequency 30,40,50 and 60 cycles/min for 2h. The PR had no distinct difference at heart wave , triangle wave and sine wave group compared with control. It is concluded that square wave and higher frequency play an important role in inhibiting A549 cells proliferation.

Quantitative observation by enzyme cytochemistry of human rectal adenocarcinoma cells killed by LAK cells

Activity of succinic dehydrogenase(SDH)and acid phosphatase(AcPase)of effector-target cells during the process of LAK cells killing HR8348 cells was estimated by enzyme cyto-chemistry technique.SHD positive granules and AePase gray level were assayed with MIAS-300image analyser.The results showed:(1)After cocultivation of effector and target cells for vari-ous times,the activity of AcPase of HR8348 cells was apparently higher than that of the controlgroup,and it increased following prolonged coincubation.SDH activity of target cells increasedmarkedly within 30 and 60 rain cocultivation,but became low after 90 min treatment.(2)Ac-Pase content within LAK cells at 60,90,120,180 and 240 rain cocultivation was significantlyhigher than that of control group(P【0.01).The phenomenon of high AcPase and SDH activitywithin effector-target cells indicates that the function of the two types of cells was in an activestate.At the early stage of effector-target combining,the increase of SDH with HR8348 cellsmay be related to defensive function of the target cells.Higher AcPase activity of target cells in-dicates the activation of lysosomal enzyme which serves as the material basis for autolysis of thecells.

Changes of NF-kB,p53,Bcl-2 and caspase in apoptosis induced by JTE-522 in human gastric adenocarcinoma cell line AGS cells:role of reactive oxygen species

AIM: To identify whether JTE-522 can induce apoptosis inAGS cells and ROS also involved in the process, and toinvestigate the changes in NF-kB, p53, bcl-2 and caspase in the apoptosis process.METHODS: Cell culture, MTT, Electromicroscopy, agarosegel electrophoresis, lucigenin, Western blot andelectrophoretic mobility shift assay (EMSA) analysis wereemployed to investigate the effect of JTE-522 on cellproliferation and apoptosis in AGS cells and relatedmolecular mechanisms.RESULTS: JTE-522 inhibited the growth of AGS cells andinduced the apoptosis. Lucigenin assay showed the generationof ROS in cells under incubation with JTE-522. The inc eareasedROS generation might contribute to the induction of AGS cellsto apoptosis. EMSA and Westem blot revealed that NF-kBactivity was almost completely inhibited by preventing thedegradation of IkBα. Additionally, by using Western blot weconfirmed that the level of bcl-2 was decreased, whereas p53showed a great increase following JTE-522 treatment. Theirchanges were in a dose-dependent manner.CONCLUSION: These findings suggest that reactive oxygenspecies, NF-kB, p53, bcl-2 and caspase-3 may play animportant role in the induction of apoptosis in AGS cellsafter treatment with JTE-522.

An immunofluorescence study on the changes of microtubulin in human rectal adenocarcinoma cells killed by LAK cells in vitro

The human rectal adenocarcinoma cell line(HR8348)was treated withlympholdne activated killer(LAK)cells in vitro and the changes of the microtubulin inboth the effector and target cells were investigated with the aid of immunofluorescencemicroscopy.It was revealed that after the attachment of LAK cells to the tumor cells,theeffector-target conjugates formed and distribution of the microtubulin in both the effectorand target cells changed.In the LAK cells,the microtubulin concentrated mainly in thecontact region,forming a crescent-like structure,while in the target cells,themicrotubulin condensed into patches and fused with the crescent-like structure of the LAKcells,Eventually,the target cells degenerated and died.It was suggested that the lysis ofthe target cells may be related to the redistribution of the microtubulin in both theeffector and target cells.

Epidemiology of EGFR Mutation in Adenocarcinoma NSCLC Patients in India: A Systematic Review and Meta-Analysis

Studies reporting the Indian prevalence of Epidermal Growth Factor Receptor (EGFR) mutation are mostly single centers with small sample sizes. This systematic review and meta-analysis summarized the available evidence of EGFR mutation epidemiology in Indian patients with adenocarcinoma (ADC) Non-Small Cell Lung Cancer (NSCLC). We conducted a structured literature search in PubMed, and EMBASE databases from January 2004 through October 2019. The primary outcome of interest was prevalence of EGFR mutation by gender, smoking status, and mutation subtype. The review included 34 studies. EGFR mutation prevalence was 39.5% in patients with ADC, and significantly higher in females, non-smokers, and patients with exon 19 deletions. The EGFR mutation frequency in Indian patients with ADC was higher than reported in Caucasians but at a lower range of that reported in East Asians. These findings support the use of EGFR mutation testing to guide choice of treatment.

A benzoxazine derivative specifically inhibits cell cycle progression in p53-wild type pulmonary adenocarcinoma cells

A fundamental aspect of cancer development is cancer cell proliferation.Seeking for chemical agents that can interfere with cancer cell growth has been of great interest over the years.In our study,we found that a benzoxazine derivative,(6-tert-butyl-3,4-dihydro-2Hbenzo[b][1,4]oxazin-3-yl)methanol(TBM),could inhibit cell growth and caused significant cell cycle arrest in pulmonary adenocarcinoma A549 and H460 cells with wild-type p53,while not affecting the cell cycle distribution in p53-deleted H1299 lung adenocarcinoma cells.Since P53 plays an important role in regulating cell cycle progression,we analyzed the protein level of p53 by Western blot,and detected a significant elevation of p53 level after TBM treatment in A549 and H460 cells.The data suggested that TBM might specifically inhibit the proliferation of p53 wild-type lung adenocarcinoma cells through a p53-dependent cell cycle control pathway.More interestingly,results indicated that TBM might serve as a useful tool for studying the molecular mechanisms of lung cancer cell growth and cell cycle control,especially for the biologic process regulated by P53.

Targeting the cell cycle in esophageal adenocarcinoma:An adjunct to anticancer treatment

Esophageal adenocarcinoma is a major cause of cancer death in men in the developed world.Continuing poor outcomes with conventional therapies that predominantly target apoptosis pathways have lead to increasing interest in treatments that target the cell cycle.A large international effort has led to the development of a large number of inhibitors,which target cell cycle kinases,including cyclin-dependent kinases,Aurora kinases and polo-like kinase.Initial phase Ⅰ/Ⅱ trials in solid tumors have often demonstrated only modest clinical benefits of monotherapy.This may relate in part to a failure to identify the patient populations that will gain the most clinical benefit.Newer compounds lacking the side effect profile of first-generation compounds may show utility as adjunctive treatments targeted to an individual's predicted response to treatment.