A More Precise Definition of Precision Medicine?

By DAVID SHAYWITZ, MD The appeal of precision medicine is the promise that we can understand disease with greater specificity and fashion treatments that are more individualized and more effective. A core tenet (or “central dogma,” as I wrote in 2015) of precision medicine is the idea that large disease categories – like type 2 diabetes – actually consist of multiple discernable subtypes, each with its own distinct characteristics and genetic drivers. As genetic and phenotypic research advances, the argument goes, diseases like “type 2 diabetes” will go the way of quaint descriptive diagnoses like “dropsy” (edema) and be replaced by more precisely defined subgroups, each ideally associated with a distinct therapy developed for that population. In 2015, this represented an intuitively appealing idea in search of robust supporting data (at least outside oncology). In 2017, this represents an intuitively appealing idea in search of robust supporting data (at least outside oncology). The gap between theory and data has troubled many researchers, and earlier this year, a pair of cardiologists from the Massachusetts General Hospital (MGH) and the Broad Institute, Sek Kathiresan and Amit V. Khera, wrote an important – and I’d suggest underappreciated – commentary in the journal Circulation that examined this very disconnect, through the lens of coronary artery disease (CAD). (Disclosures: I’m Chi...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Broad Institute CAD Circulation Disease Categories Gimish Model of Disease Kathiresan Khera Massachussetts General Hospital Source Type: blogs

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More than a third of patients with diabetes don't take their drugs as prescribed, sometimes because of cost concerns.
Source: Health News: CBSNews.com - Category: Consumer Health News Source Type: news
This article gives an overview of the current results of PET with radiolabelled amino acids in therapy monitoring of standard therapy as well as various innovative approaches in the treatment of patients with cerebral gliomas.Expert opinion: Amino acid PET has proven to be helpful in therapy monitoring of gliomas, the costs are low in relation to the costs of therapy and the clinical benefit, and a widespread clinical use is highly desirable. PMID: 31829748 [PubMed - as supplied by publisher]
Source: Expert Review of Neurotherapeutics - Category: Neurology Tags: Expert Rev Neurother Source Type: research
Conclusions: In patients discontinuing natalizumab, fingolimod has a favorable benefit–risk profile over 48 months. These findings also suggest using a short washout following natalizumab discontinuation, consistent with guidelines and current clinical practice in Germany.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
Publication date: Available online 13 December 2019Source: Brain, Behavior, and ImmunityAuthor(s): N.B. Teixeira, M.B. Sant'Anna, A.C. Giardini, L.P. Araujo, L.A. Fonseca, A.S. Basso, Y. Cury, G. PicoloAbstractMultiple sclerosis (MS) is a Central Nervous System inflammatory demyelinating disease that has as primary symptoms losses of sensory and motor functions, including chronic pain. To date, however, few studies have investigated the mechanisms of chronic pain in animal models of MS since locomotor impairments render difficult its evaluation. It was previously demonstrated that in the MOG35-55-induced EAE, an animal mod...
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
Among women with metastatic breast cancer, use of an investigational oral form of paclitaxel yielded a higher overall response rate than the IV form, but administration was unique and time-consuming.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Hematology-Oncology News Source Type: news
Publication date: Available online 12 December 2019Source: The LancetAuthor(s): Jack Cuzick, Ivana Sestak, John F Forbes, Mitch Dowsett, Simon Cawthorn, Robert E Mansel, Sibylle Loibl, Bernardo Bonanni, D Gareth Evans, Anthony Howell, IBIS-II investigatorsSummaryBackgroundTwo large clinical trials have shown a reduced rate of breast cancer development in high-risk women in the initial 5 years of follow-up after use of aromatase inhibitors (MAP.3 and International Breast Cancer Intervention Study II [IBIS-II]). Here, we report blinded long-term follow-up results for the IBIS-II trial, which compared anastrozole with placebo...
Source: The Lancet - Category: General Medicine Source Type: research
Publication date: Available online 12 December 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Chien-Lin Chen, Wei-Chuan Chang, Ching-Sheng Hsu
Source: Journal of the Formosan Medical Association - Category: General Medicine Source Type: research
Publication date: Available online 12 December 2019Source: Clinics and Research in Hepatology and GastroenterologyAuthor(s): Jean-Pierre Zarski, Sandra David-Tchouda, Candice Trocme, Jennifer Margier, Antoine Vilotitch, Marie-Noelle Hilleret, Carole Cagnot, Valerie Boursier, Marianne Ziol, Angela Sutton, Richard Layese, Etienne Audureau, Francoise Roudot-Thoraval, Pierre NahonSummaryBackground and AimsMarkers predicting complications of post-hepatitis C cirrhosis are needed. We asked whether changes in noninvasive markers of fibrosis can predict liver-related complications.MethodsThis was a case-controlled study using a pr...
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research
ConclusionsMHSCC seems to show a better overall survival compared to OSCC of other locations and is less likely to develop regional and distant metastasis; END might not be necessary in early stage tumors.
Source: Journal of Cranio Maxillofacial Surgery - Category: ENT & OMF Source Type: research
By DAVID SHAYWITZ, MD The appeal of precision medicine is the promise that we can understand disease with greater specificity and fashion treatments that are more individualized and more effective. A core tenet (or “central dogma,” as I wrote in 2015) of precision medicine is the idea that large disease categories – like type 2 diabetes – actually consist of multiple discernable subtypes, each with its own distinct characteristics and genetic drivers. As genetic and phenotypic research advances, the argument goes, diseases like “type 2 diabetes” will go the way of quaint descriptive...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: OP-ED Uncategorized Broad Institute CAD Circulation Disease Categories Gimish Model of Disease Kathiresan Khera Massachussetts General Hospital Source Type: blogs
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