"2009 ; Pitts , 2008 ] . It is also interesting to consider the ethical issues of developing predictive tests that , due to cost , may not be available to the majority of the world ' s population , and may not even be cost effective for affluent populations [ Ioannidis , 2009 ] . "
[Show abstract][Hide abstract] ABSTRACT: Over the last 10 years there has been an explosion of information about the molecular biology of cancer. A challenge in oncology is to translate this information into advances in patient care. While there are well-formed routes for translating new molecular information into drug therapy, the routes for translating new information into sensitive and specific diagnostic, prognostic and predictive tests are still being developed. Similarly, the science of using tumor molecular profiles to select clinical trial participants or to optimize therapy for individual patients is still in its infancy. This review will summarize the current technologies for predicting treatment response and prognosis in cancer medicine, and outline what the future may hold. It will also highlight the potential importance of methods that can integrate molecular, histopathological and clinical information into a synergistic understanding of tumor progression. While these possibilities are without doubt exciting, significant challenges remain if we are to implement them with a strong evidence base in a widely available and cost-effective manner.
rapeutic Advances in Medical Oncology, The 03/2010; 2(2):125-48. DOI:10.1177/1758834009360519 · 2.83 Impact Factor
"Direct-to-consumer genome risk profiling has been available since 2007 for a plethora of conditions and traits. Even as many genetic association findings have been commercialized, debates continue about evidence of clinical validity and utility (Attia et al. 2009; Hunter et al. 2008; Ioannidis 2009), approaches to risk communication (Kraft et al. 2009), role of health professionals (Haga and Willard 2008), and the psychosocial , behavioral, and public health impact(s) (McBride et al. 2008). In recent years, several studies have been initiated to address pieces of the genomic risk puzzle: the Personal Genome Project (Church 2005), The Multiplex Initiative (McBride et al. 2008) and the Coriell Personalized Medicine Collaborative (Christman 2008). "
[Show abstract][Hide abstract] ABSTRACT: With the expansion of genomic-based clinical applications, it is important to consider the potential impact of this information particularly in terms of how it may be interpreted and applied to personal perceptions of health. As an initial step to exploring this question, we conducted a study to gain insight into potential psychosocial and health motivations for, as well as impact associated with, undergoing testing and disclosure of individual "variomes" (catalogue of genetic variations). To enable the collection of fully informed opinions, 14 participants with advanced training in genetics underwent whole-genome profiling and received individual reports of estimated genomic ancestry, genotype data and reported disease associations. Emotional, cognitive and health behavioral impact was assessed through one-on-one interviews and questionnaires administered pre-testing and 1-week and 3-months post-testing. Notwithstanding the educational and professional bias of our study population, the results identify several areas of research for consideration within additional populations. With the development of new and less costly approaches to genome risk profiling, now available for purchase direct-to-consumers, it is essential that genome science research be conducted in parallel with studies assessing the societal and policy implications of genome information for personal use.
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