Precision oncology using ex vivo technology: a step towards individualised cancer care?

IF 4.5 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Expert Reviews in Molecular Medicine Pub Date : 2022-10-03 DOI:10.1017/erm.2022.32
Sophie T Williams, Greg Wells, Samantha Conroy, Hannah Gagg, Richard Allen, Ola Rominiyi, Thomas Helleday, Katie Hullock, Catherine E W Pennington, Juha Rantala, Spencer J Collis, Sarah J Danson
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引用次数: 2

Abstract

Despite advances in cancer genomics and the increased use of genomic medicine, metastatic cancer is still mostly an incurable and fatal disease. With diminishing returns from traditional drug discovery strategies, and high clinical failure rates, more emphasis is being placed on alternative drug discovery platforms, such as ex vivo approaches. Ex vivo approaches aim to embed biological relevance and inter-patient variability at an earlier stage of drug discovery, and to offer more precise treatment stratification for patients. However, these techniques also have a high potential to offer personalised therapies to patients, complementing and enhancing genomic medicine. Although an array of approaches are available to researchers, only a minority of techniques have made it through to direct patient treatment within robust clinical trials. Within this review, we discuss the current challenges to ex vivo approaches within clinical practice and summarise the contemporary literature which has directed patient treatment. Finally, we map out how ex vivo approaches could transition from a small-scale, predominantly research based technology to a robust and validated predictive tool. In future, these pre-clinical approaches may be integrated into clinical cancer pathways to assist in the personalisation of therapy choices and to hopefully improve patient experiences and outcomes.

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使用离体技术的精确肿瘤学:迈向个体化癌症治疗的一步?
尽管癌症基因组学取得了进展,基因组医学的使用也有所增加,但转移性癌症仍然是一种无法治愈和致命的疾病。随着传统药物发现策略的收益递减和高临床失败率,人们越来越重视替代药物发现平台,如体外方法。体外方法旨在在药物发现的早期阶段嵌入生物学相关性和患者间可变性,并为患者提供更精确的治疗分层。然而,这些技术也有很大的潜力为患者提供个性化治疗,补充和加强基因组医学。尽管研究人员可以使用一系列方法,但只有少数技术能够在可靠的临床试验中直接用于患者治疗。在这篇综述中,我们讨论了目前在临床实践中离体方法的挑战,并总结了指导患者治疗的当代文献。最后,我们描绘了离体方法如何从一个小规模的、主要基于研究的技术转变为一个强大的、经过验证的预测工具。未来,这些临床前方法可能会整合到临床癌症途径中,以帮助治疗选择的个性化,并有望改善患者的体验和结果。
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来源期刊
Expert Reviews in Molecular Medicine
Expert Reviews in Molecular Medicine BIOCHEMISTRY & MOLECULAR BIOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
7.40
自引率
1.60%
发文量
45
期刊介绍: Expert Reviews in Molecular Medicine is an innovative online journal featuring authoritative and timely Reviews covering gene therapy, immunotherapeutics, drug design, vaccines, genetic testing, pathogenesis, microbiology, genomics, molecular epidemiology and diagnostic techniques. We especially welcome reviews on translational aspects of molecular medicine, particularly those related to the application of new understanding of the molecular basis of disease to experimental medicine and clinical practice.
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