The Singapore National Precision Medicine Strategy.
Wong Eleanor et al. Nature genetics 2023 1
The 10-year initiative aims to generate precision medicine data of up to one million individuals, integrating genomic, lifestyle, health, social and environmental data. Beyond technologies, routine adoption of precision medicine in clinical practice requires social, ethical, legal and regulatory barriers to be addressed. Identifying driver use cases in which precision medicine results in standardized changes to clinical workflows or improvements in population health, coupled with health economic analysis to demonstrate value-based healthcare, is a vital prerequisite for responsible health system adoption.
Precision medicine: affording the successes of science.
Lu Christine Y et al. NPJ precision oncology 2023 1 (1) 3
Drug development in ever-smaller target populations is a critical component of the rising costs of care. For structural and historical reasons, drug development is inefficient and poorly integrated across the public and private sectors. We postulate an alternative, integrated model in which governments and industry share the risks and benefits of drug development.
Implementation of Whole-Genome and Transcriptome Sequencing Into Clinical Cancer Care.
Cuppen Edwin et al. JCO precision oncology 2022 12 e2200245
We review the current studies implementing WGTS in health care systems and provide a synopsis of the clinical evidence and insights into practical considerations for WGTS implementation. We reflect on regulatory, costs, reimbursement, and incidental findings aspects of this test. WGTS is an appropriate comprehensive clinical test for many tumor types and can replace multiple, cascade testing approaches currently performed.
Predicting tumour radiosensitivity to deliver precision radiotherapy.
Price James M et al. Nature reviews. Clinical oncology 2022 12
Owing to advances in radiotherapy, physical properties of radiation can be optimized to enable individualized treatment; however, optimization is rarely based on biological properties and, therefore, treatments are generally planned with the assumption that all tumors respond similarly. Radiation affects multiple cellular pathways, including DNA damage, hypoxia, proliferation, stem cell phenotype and immune response. In this Review, we summarize the effect of these pathways on tumor responses to radiotherapy and the current state of research on genomic classifiers designed to exploit these variations to inform treatment decisions