Medicine:Individualized medicine

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Short description: Type of medical treatment


Individualized medicine tailors treatment to a single patient. The term refers to an individual, truly personalized medicine that strives to treat each patient on the basis of his own individual biology.

Individualized medicine represents a further individualization of personalized medicine. While the latter is aimed at a specific group of patients, individualized medicine deals with the individual circumstances of a single person. Thus, individualized medicine goes one step further and can be considered as an increase in personalized medicine.

Individualized medicine seeks to derive tailored therapies for individuals by taking into account a person's genes as well as the full range of that person's unique nature, including biological, physiological and anatomical information.

Background

Individualized medicine was first mentioned in the literature in 2003 and described the individual drug metabolism in pharmacogenomics.[1][2] Subsequently, the term was used to improve diagnosis based on genetic differences and physiological information and to better tailor the treatment to the needs of a single patient.[3][4][2]

More recently, a second context has been introduced that relates to therapeutic approaches that use a person's own cell material to develop a treatment that is unique to the patient from whom the material originated.[2] Examples are stem-cell therapies[5] and cancer vaccines,[6] which are based on individually distinct molecular profiles.[7][8]

Genome research

Genome research has led to new resources that allow more accurate diagnosis and disease management to be tailored to each patient.[2] The challenge of health research is to maximize therapeutic efficacy for each patient while minimizing side effects. An individual medicine approach may be required for those patients who cannot be categorized by mainstream personalized medicine or who suffer diseases without effective drug therapies. The widespread use of advanced imaging techniques and high-throughput technologies that allow for the in-depth study of genes, proteins, and metabolites provides a better understanding of the molecular processes involved in the origin and progression of a disease.[2] Along with other information, these data form the basis for the development of new diagnostic technologies and treatment approaches that are customized for each individual patient.

Individualized medicine in oncology

Individualized medicine is playing an increasingly important role, especially in oncology, given that cancers can be extremely heterogeneous between individual patients and within the tumor itself.[9] For example, individualized cancer immunotherapy with the production of vaccines tailored to match a person's individual constellation of cancer mutations, the mutanome, has become a new field of research.[10][11][12][13][14][15][16][17][18][19][20] Each patient has an individual mutational signature, and only a very small portion of the mutations are shared between patients.[21][12] The aim of individualized medicine is to optimize the treatment strategy for a single patient using genetic information as well as molecular and cellular analyzes.

References

  1. ↑ Srivastava, P (2003). "Drug metabolism and individualized medicine". Curr Drug Metab 4 (1): 33–44. doi:10.2174/1389200033336829. PMID 12570744. 
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Pokorska-Bocci, A; Stewart, A; Sagoo, GS; Hall, A; Kroese, M; Burton, H (2014). "'Personalized medicine': what's in a name?". Personalized Medicine 11 (2): 197–210. doi:10.2217/pme.13.107. PMID 29751382. 
  3. ↑ Hall, JG (2003). "Individualized medicine. What the genetic revolution will bring to health care in the 21st century". Can Fam Physician 49 (1): 12–13. PMID 12602834. 
  4. ↑ Hoffman, MA; Williams, MS (2011). "Electronic medical records and personalized medicine". Hum Genet 130 (1): 33–39. doi:10.1007/s00439-011-0992-y. PMID 21519832. 
  5. ↑ Baker, M (2011). "Reprogramming Rx". Nat Med 17 (3): 241–243. doi:10.1038/nm0311-241. PMID 21383713. 
  6. ↑ Gravitz, L (2011). "A fight for life that united a field". Nature 478 (7368): 163–164. doi:10.1038/478163a. PMID 21993732. Bibcode: 2011Natur.478..163G. 
  7. ↑ Graham-Rowe, D (2011). "Overview: Multiple lines of attack". Nature 480 (7377): S34–S35. doi:10.1038/480S34a. PMID 22169797. Bibcode: 2011Natur.480S..34G. 
  8. ↑ Humphries, C (2011). "Genetics: Profiling a shape-shifter". Nature 480 (7377): S50–S51. doi:10.1038/480S50a. PMID 22169804. Bibcode: 2011Natur.480S..50H. 
  9. ↑ Chen, DS; Mellman, I (2017). "Elements of cancer immunity and the cancer-immune set point". Nature 541 (7637): 321–330. doi:10.1038/nature21349. PMID 28102259. Bibcode: 2017Natur.541..321C. 
  10. ↑ Hilf, N; Kuttruff-Coqui, S; Frenzel, K; Bukur, V; Stevanović, S; Gouttefangeas, C; Platten, M; Tabatabai, G et al. (2019). "Actively personalized vaccination trial for newly diagnosed glioblastoma". Nature 565 (7738): 240–245. doi:10.1038/s41586-018-0810-y. PMID 30568303. Bibcode: 2019Natur.565..240H. https://eprints.soton.ac.uk/427865/1/GAPVAC_manuscript_181105_clean.docx. 
  11. ↑ Keskin, DB; Anandappa, AJ; Sun, J; Tirosh, I; Mathewson, ND; Li, S; Oliveira, G; Giobbie-Hurder, A et al. (2019). "Neoantigen vaccine generates intratumoral T cell responses in phase Ib glioblastoma trial". Nature 565 (7738): 234–239. doi:10.1038/s41586-018-0792-9. PMID 30568305. 
  12. ↑ 12.0 12.1 Vormehr, M; Türeci, Ö; Sahin, U (2019). "Harnessing Tumor Mutations for Truly Individualized Cancer Vaccines". Annu Rev Med 70: 395–407. doi:10.1146/annurev-med-042617-101816. PMID 30691374. 
  13. ↑ Türeci, Ö; Löwer, M; Schrörs, B; Lang, M; Tadmor, A; Sahin, U (2018). "Challenges towards the realization of individualized cancer vaccines". Nat Biomed Eng 2 (8): 566–569. doi:10.1038/s41551-018-0266-2. PMID 31015635. 
  14. ↑ Sahin, U; Derhovanessian, E; Miller, M; Kloke, BP; Simon, P; Löwer, M; Bukur, V; Tadmor, AD et al. (2017). "Personalized RNA mutanome vaccines mobilize poly-specific therapeutic immunity against cancer". Nature 547 (7662): 222–226. doi:10.1038/nature23003. PMID 28678784. Bibcode: 2017Natur.547..222S. 
  15. ↑ Ott, PA; Hu, Z; Keskin, DB; Shukla, SA; Sun, J; Bozym, DJ; Zhang, W; Luoma, A et al. (2017). "An immunogenic personal neoantigen vaccine for patients with melanoma". Nature 547 (7662): 217–221. doi:10.1038/nature22991. PMID 28678778. Bibcode: 2017Natur.547..217O. 
  16. ↑ Kranz, LM; Diken, M; Haas, H; Kreiter, S; Loquai, C; Reuter, KC; Meng, M; Fritz, D et al. (2016). "Systemic RNA delivery to dendritic cells exploits antiviral defence for cancer immunotherapy". Nature 534 (7607): 396–401. doi:10.1038/nature18300. PMID 27281205. Bibcode: 2016Natur.534..396K. 
  17. ↑ Kreiter, S; Vormehr, M; van de Roemer, N; Diken, M; Löwer, M; Diekmann, J; Boegel, S; Schrörs, B et al. (2015). "Mutant MHC class II epitopes drive therapeutic immune responses to cancer". Nature 520 (7549): 692–696. doi:10.1038/nature14426. PMID 25901682. Bibcode: 2015Natur.520..692K. 
  18. ↑ Carreno, BM; Magrini, V; Becker-Hapak, M; Kaabinejadian, S; Hundal, J; Petti, AA; Ly, A; Lie, WR et al. (2015). "Cancer immunotherapy. A dendritic cell vaccine increases the breadth and diversity of melanoma neoantigen-specific T cells". Science 348 (6236): 803–808. doi:10.1126/science.aaa3828. PMID 25837513. 
  19. ↑ Castle, JC; Kreiter, S; Diekmann, J; Löwer, M; van de Roemer, N; de Graaf, J; Selmi, A; Diken, M et al. (2012). "Exploiting the mutanome for tumor vaccination". Cancer Res 72 (5): 1081–1091. doi:10.1158/0008-5472.CAN-11-3722. PMID 22237626. 
  20. ↑ Kreiter, S; Selmi, A; Diken, M; Koslowski, M; Britten, CM; Huber, C; Türeci, O; Sahin, U (2010). "Intranodal vaccination with naked antigen-encoding RNA elicits potent prophylactic and therapeutic antitumoral immunity". Cancer Res 70 (22): 9031–9040. doi:10.1158/0008-5472.CAN-10-0699. PMID 21045153. 
  21. ↑ Kreiter, S; Castle, JC; Türeci, Ö; Sahin, U (2012). "Targeting the tumor mutanome for personalized vaccination therapy". Oncoimmunology 1 (5): 768–769. doi:10.4161/onci.19727. PMID 22934277. 



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