| 1. |
- Ferreira, PE, et al.
(author)
-
Pharmacogenetic tools for malaria and TB in the Developing World
- 2008
-
In: Personalized medicine. - : Future Medicine Ltd. - 1744-828X .- 1741-0541. ; 5:6, s. 627-639
-
Journal article (peer-reviewed)abstract
- Some of the largest therapeutic drug exposures in the planet involve drugs employed against malaria and TB, two main global infectious diseases. Amodiaquine for malaria and isoniazid for TB are two pivotal drugs in the management of these diseases. Both drugs have been associated with severe adverse events. Amodiaquine and isoniazid are metabolized polymorphically by CYP2C8 and N-acetyltransferase 2, respectively. The polymorphic genes coding for these enzymes presently represent the best candidates for the application of personal pharmacogenetics for these diseases. We review the main reasons for this view, while asking the pivotal question of whether it is presently possible for pharmacogenetic-based personalized medicine to be applied in the malaria and TB settings of the Developing World.
|
|
| 2. |
- Hamilton, J. G., et al.
(author)
-
Clinician perspectives on communication and implementation challenges in precision oncology
- 2021
-
In: Personalized Medicine. - : Future Medicine Ltd. - 1741-0541 .- 1744-828X. ; 18:6, s. 559-572
-
Journal article (peer-reviewed)abstract
- Aim: To describe patient communication challenges encountered by oncology clinicians, which represent a fundamental barrier to implementing precision oncology. Materials & methods: We conducted three focus groups including breast, melanoma and thoracic oncology clinicians regarding their precision oncology communication experiences. Transcripts were reviewed and coded using inductive thematic text analysis. Results: We identified four themes: varied definitions of precision oncology exist, clinicians and patients face unique challenges to precision oncology implementation, patient communication challenges engendered or heightened by precision oncology implementation and clinician communication solutions and training needs. Conclusion: This study elucidated clinicians' perspectives on implementing precision oncology and related communication challenges. Understanding these challenges and developing strategies to help clinicians navigate these discussions are critical for ensuring that patients reap the full benefits of precision oncology. Lay abstract Aim: 'Precision oncology' has gained momentum as a term to describe cancer care that is optimized for an individual patient based on her/his unique characteristics. However, clinicians may encounter challenges with communication when delivering precision oncology care to patients and their families. Materials & methods: We conducted three focus groups, or structured discussions, with breast, melanoma and thoracic oncology clinicians regarding their precision oncology communication experiences. Narrative transcripts of these discussions were analyzed by the research team to identify common themes. Results: We identified four themes: varied definitions of precision oncology exist, clinicians and patients face unique challenges to precision oncology implementation, patient communication challenges engendered or heightened by precision oncology implementation, and clinician communication solutions and training needs. Conclusion: This study elucidated clinicians' perspectives on delivering precision oncology and related communication challenges. Understanding these challenges and developing strategies to help clinicians navigate these discussions are critical for ensuring that patients reap the full benefits of precision oncology.
|
|
| 3. |
- Hansson, Mats G.
(author)
-
Taking the patient's side : the ethics of pharmacogenetics
- 2010
-
In: Personalized Medicine. - : Future Medicine Ltd. - 1741-0541 .- 1744-828X. ; 7:1, s. 75-85
-
Journal article (peer-reviewed)abstract
- From the perspective of current and future patients, the development of the field of pharmacogenetics is of immense interest. The encouraging vision that is now being established is that we may move from trial and error therapies to evidence-based personalized medicine in clinical practice. However, research and the application of pharmacogenetics to clinical practice are believed to raise a host of controversial ethical issues. Some of these are related to the research process, for example, confidentiality and informed consent in association with human tissue sampling. Other issues arise on a societal level, for example, issues regarding justice and the use of race or ethnicity as proxies for genotyping. in this perspective, I comment on this debate and also suggest what we may learn from previous discussions regarding DNA testing and gene transfer methods. Arguably, the most important ethical perspective in medical research and drug development is related to the interests of patients wanting medical treatment that is both effective and carries low risks of adverse effects. Risk:benefit ratios must always be compared with existing alternatives, and while the risk of adverse effects may be tolerable for some individuals, owing to genetic reasons, this may not be relevant for others. This will have consequences for regulatory policies regarding drug development. In the future, personalized medicine will also need to take epigenetic and environmental factors into consideration.
|
|
| 4. |
- Kalokairinou, Louiza, et al.
(author)
-
'It's much more grey than black and white' : clinical geneticists' views on the oversight of consumer genomics in Europe
- 2020
-
In: Personalized Medicine. - : FUTURE MEDICINE LTD. - 1741-0541 .- 1744-828X. ; 17:2, s. 129-140
-
Journal article (peer-reviewed)abstract
- Aim: Direct-to-consumer (DTC) genetic tests (GT) have created controversy regarding their risks and benefits. In view of recent regulatory developments, this article aims to explore the attitudes of European clinical geneticists toward the oversight of DTC GT.Materials & methods: Fifteen semi-structured interviews were performed with clinical geneticists based in ten European countries. The transcripts were thematically analysized in an iterative process.Results & conclusion: Respondents strongly supported quality standards for DTC GT equal to those applied within the healthcare setting. Despite participants unanimously considering the involvement of healthcare professionals to be important, mandatory medical supervision was controversial. In this regard, promoting education and truth-in-advertising was considered as being key in maintaining a balance between protecting consumers and promoting their autonomy.
|
|
| 5. |
- Middleton, Anna, et al.
(author)
-
Direct-to-consumer genetic testing : where and how does genetic counseling fit?
- 2017
-
In: Personalized Medicine. - : FUTURE MEDICINE LTD. - 1741-0541 .- 1744-828X. ; 14:3, s. 249-257
-
Journal article (peer-reviewed)abstract
- Direct-to-consumer genetic testing for disease ranges from well-validated diagnostic and predictive tests to 'research' results conferring increased risks. While being targeted at public curious about their health, they are also marketed for use in reproductive decision-making or management of disease. By virtue of being 'direct-to-consumer' much of this testing bypasses traditional healthcare systems. We argue that direct-to-consumer genetic testing companies should make genetic counseling available, pre- as well as post-test. While we do not advocate that mandatory genetic counseling should gate-keep access to direct-to-consumer genetic testing, if the testing process has the potential to cause psychological distress, then companies have a responsibility to provide support and should not rely on traditional healthcare systems to pick up the pieces.
|
|
| 6. |
- Middleton, Anna, et al.
(author)
-
'Your DNA, Your Say': global survey gathering attitudes toward genomics : design, delivery and methods
- 2018
-
In: Personalized Medicine. - : Future Medicine Ltd. - 1741-0541 .- 1744-828X. ; 15:4, s. 311-318
-
Journal article (peer-reviewed)abstract
- Our international study, 'Your DNA, Your Say', uses film and an online cross-sectional survey to gather public attitudes toward the donation, access and sharing of DNA information. We describe the methodological approach used to create an engaging and bespoke survey, suitable for translation into many different languages. We address some of the particular challenges in designing a survey on the subject of genomics. In order to understand the significance of a genomic result, researchers and clinicians alike use external databases containing DNA and medical information from thousands of people. We ask how publics would like their 'anonymous' data to be used (or not to be used) and whether they are concerned by the potential risks of reidentification; the results will be used to inform policy.
|
|
| 7. |
- Niemiec, Emilia, Dr, et al.
(author)
-
Current ethical and legal issues in health-related direct-to-consumer genetic testing
- 2017
-
In: Personalized Medicine. - : Future Medicine Ltd. - 1741-0541 .- 1744-828X. ; 14:5, s. 433-445
-
Research review (peer-reviewed)abstract
- A variety of health-related genetic testing is currently advertized directly to consumers. This article provides a timely overview of direct-to-consumer genetic testing (DTC GT) and salient ethical issues, as well as an analysis of the impact of the recently adopted regulation on in vitro diagnostic medical devices on DTC GT. DTC GT companies currently employ new testing approaches, report on a wide spectrum of conditions and target new groups of consumers. Such activities raise ethical issues including the questionable analytic and clinical validity of tests, the adequacy of informed consent, potentially misleading advertizing, testing in children, research uses and commercialization of genomic data. The recently adopted regulation on in vitro diagnostic medical devices may limit the offers of predisposition DTC GT in the EU market.
|
|
| 8. |
- Ormond, Kelly E., et al.
(author)
-
The clinical application of gene editing : ethical and social issues
- 2019
-
In: Personalized Medicine. - : Future Medicine Ltd. - 1741-0541 .- 1744-828X. ; 16:4, s. 337-350
-
Journal article (peer-reviewed)abstract
- Gene-editing techniques have progressed rapidly in the past 5years. There are already ongoing human somatic gene-editing clinical trials for multiple diseases. And there has been one purported scenario of human germline gene editing in late 2018. In this paper, we will review the current state of the technology, discuss the ethical and social issues that surround the various forms of gene editing, as well as review emerging stakeholder data from professionals, the general public' and individuals and families dealing with genetic diseases potentially treatable by gene editing.
|
|
| 9. |
- Tuzmen, S, et al.
(author)
-
Characterization of farnesyl diphosphate farnesyl transferase 1 (FDFT1) expression in cancer
- 2019
-
In: Personalized medicine. - : Future Medicine Ltd. - 1744-828X .- 1741-0541. ; 16:1, s. 51-65
-
Journal article (peer-reviewed)abstract
- Aim: To help characterize the FDFT1 gene and protein expression in cancer. Cholesterol represents an important structural component of lipid rafts. These specializations can be involved in pathways stimulating cell growth, survival and other processes active in cancer. This cellular compartment can be expanded by acquisition of cholesterol from the circulation or by its synthesis in a metabolic pathway regulated by the FDFT1 enzyme. Given the critical role this might play in carcinogenesis and in the behavior of cancers, we have examined the level of this enzyme in various types of human cancer. Our demonstration of elevated levels of FDFT1 mRNA and protein in some tumors relative to surrounding normal tissue identifies this as a possible biomarker for disease development and progression, and as a potential new target for the treatment of cancer.
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
- Danielsson, Krissi, et al.
(author)
-
Personalizing pancreatic cancer medicine: what are the challenges?
- 2013
-
In: Personalized Medicine. - 1744-828X. ; 10:1, s. 45-59
-
Research review (peer-reviewed)abstract
- The P4 paradigm for future medicine promises changes in cancer management with improved Prediction of treatment response, Prevention of disease, Personalization of therapy, and Participation by patients. Significant challenges remain for the implementation of the P4 principles for pancreatic cancer, but many strides have been made in the past several years that should facilitate a future in which the disease can be detected at earlier stages and treatments can be customized to target features of a particular patient's disease. This article summarizes the basic molecular biology of pancreatic tumors and the current state of pancreatic cancer treatment, as well as targeted treatments in the pipeline that might enable future personalized pancreatic cancer treatment and prediction of response to treatment. It also discusses possible directions for screening patients at high risk of developing the disease, detecting tumors at earlier stages, and increasing patient involvement in designing treatment.
|
|
| 13. |
|
|
