Release date: 2018-03-22
Although precision medicine has made significant progress in anti-cancer, its research on the “number one†health killer – cardiovascular disease has progressed slowly. However, it is foreseeable that with the rapid development of high-throughput sequencing technology, the future treatment model of cardiovascular disease will inevitably turn to focus on highly individualized treatment variables.
Before President Obama announced the “Precision Medical Plan†in 2015, scientists and medical researchers have worked to determine the underlying genetic factors of the disease and to find specific treatments for decades. So far, the application of precision medical methods has made great progress in a series of therapeutic fields, especially on the field of oncology, but at the same time, research in the field of cardiology is slightly behind.
Widely used in oncology
“Accurate medicine†is an emerging approach to disease prevention and treatment that takes into account differences in personal genetics, environment and lifestyle. In the exploration of drugs, precision medicine is a deep understanding of the homogeneity and heterogeneity of specific diseases and patient groups. When understanding the uniform characteristics of diseases, targeted therapy can be carried out.
This method has been widely and successfully applied in the field of oncology, and the origin and genetic characteristics of the patient's tumor are regularly analyzed in depth before the recommended treatment. The approved anti-tumor drug pembrolizumab (Keytruda) is suitable for patients with solid tumors in any position with a certain genetic defect; another drug, tissuelecleucel (Kymirah), is a CAR-T cell therapy drug that utilizes individual patients. The gene de-modifies T cells to target killing of leukemia cells. These two drugs are two interesting examples of progress in precision drug treatment of cancer.
Moreover, precision medical methods have also shown traction for certain orphans or rare diseases, most notably in the treatment of cystic fibrosis. Identification of genetic mutations is not only used to guide recently approved treatments, but also for The patient's expected response to treatment is predicted.
Cardiology is catching up
Cardiology has been slow in precision drug therapy, mainly because cardiologists have so far focused on changing environmental factors that cause coronary artery disease and peripheral arterial disease, such as smoking, obesity, and lack of exercise. These controllable risk factors have been identified through a large population-based registry and have been effective in reducing cardiovascular morbidity and mortality.
However, the need for innovative heart disease treatment remains critical. Cardiovascular disease remains the world's biggest killer, with only 2% of the breakthrough results awarded by the FDA in 2017 being used to treat cardiovascular or kidney disease, and nearly 30% in oncology, accounting for 30% of the field of hematology. 20%.
However, with the influence of incentives, this situation is likely to change: the application of precision medical methods is a well-defined subset of patients, identifying molecular targets associated with the disease basis and biomarkers that can measure target effects early in development. This in turn makes it easier for biotech and pharmaceutical companies to pursue cardiovascular drug development in a targeted manner, and clinical trials may require only a few specific subgroups of patients to demonstrate the safety and efficacy of the drug.
The precision medical industry is already working together to find some solutions. In 2017, the American Heart Association opened up their precision medical platform, allowing researchers and doctors from around the world to analyze the Cedars-Sinai Heart Institute and the Duke Clinical Institute. A large number of cardiovascular data from numerous institutions including the Duke Clinical Research Institute and Stanford University.
Hereditary cardiovascular diseases such as hypertrophic, restricted and dilated cardiomyopathy, hereditary arrhythmias such as LongQT and Brugada syndrome, familial hyperlipidemia and genetic disorders that cause vascular disease such as Marfan syndrome, Became the initial goal of industry-academic mutual cooperation, in order to achieve new breakthroughs in diagnosis and treatment.
Research cases have emerged for gene therapy of cardiomyopathy caused by genetic factors. For example, the Oregon Health Sciences University is developing a medical treatment for the treatment of hypertrophic cardiomyopathy. Another example of academic collaboration in the industry is the Muscle Creatine Cardiomyopathy Registry (SHaRe), an international database of clinical and laboratory data from researchers around the world dedicated to better understanding the genetics of patients with cardiomyopathy. Foundation, commonality and difference. Similar efforts have led to the development of precision medicine for specific heart diseases, as well as a blueprint for effective treatment of other cardiovascular diseases.
a promising future
As with any major change in medical practice, the process by which precision medicine seeks to establish its relevance in the field of cardiology is slow. However, recent striking advances in other therapeutic areas have demonstrated the potential between subgroups of patients who can benefit from targeted therapies and precision cardiac therapy. In cardiovascular disease, precision medicine can bring much-needed innovation to the field and ultimately change the way we treat heart disease.
Source: Bio-Exploration
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