New strategies of clinical precision medicine

• Published in: Clinical and translational medicine 2022-02, Vol.12 (2), p.e135-n/a
• Main Author: Wang, Xiangdong
• Format: Article
• Language: English
• Subjects: Biomarkers; Cancer therapies; Clinical medicine; Decision making; Drugs; Evidence-based medicine; Humans; Medical prognosis; Metabolism; Metastasis; Mutation; Patients; Precision medicine; Precision Medicine - methods; Precision Medicine - trends
• ISSN: 2001-1326; 2001-1326
• DOI: 10.1002/ctm2.135

A precise self-validation system was proposed as a new approach of precision medicine to screen and optimize therapeutic strategies of individual's treatment by scanning the targeted drug efficacy and specificity in the patient's own cancer cells.3 A protein structure–guided compound screening or a DNA-encoded chemical library based on pharmacogenomic profiles, gene mutations, self-validation systems, and heterogeneity could prove beneficial in the development of clinical precision medicine. The efficacy of precision medicine strategy should be monitored by disease-specific biomarkers with specificities of disease duration, stage, severity, and drug response.5,6 Laes et al analyzed the molecular profiles of 1057 advanced cancer patient samples after failing at least one standard of care treatment and discovered that the combination of next-generation sequencing, immunohistochemistry, and other specific tests provided better information compared to utilizing each method separately.7 The performance of precision medicine strategy is highly correlated to the effort and understanding the clinician possesses with regard to the strategy, the availability and cost of target drugs, and the cancer types and severities. The precision medicine is a part of genomic medicine and clinical and translational medicine to translate mutation-based or sequencing-evidenced therapy and strategy into clinical practice, monitor the disease progression using gene-based biomarkers, predict the patient prognosis using transcriptional networks and interactions, prevent the disease occurrence using germline heterogeneity and genetic background, integrate gene mutations with pharmacogenomic profiles, and optimize the strategy of precision medicine for individuals. The process of translating clinical precision medicine into new regulations and policies has been initiated, for example, molecular testing guideline for target-based therapies in patients with cancer.14 The intercommunication and interaction between immune and metabolic checkpoints and gut microbiota were suggested as a source to generate new therapeutic targets and could aid in developing new strategies.11,15 Clinical trans-omics is a new approach that can integrate molecular multi-omics with clinical phenomics and can present the full landscape of patient phenome-based molecular networks to identify diagnostic biomarkers and therapeutic targets.13 Clinical trans-omics as a systemic and comprehensive discipline can be criti