Trends and applications in personalised laboratory medicine involve the application of newer drugs in cancer therapy, such as epidermal growth factor receptor (EGFR) inhibitors in lung cancer and can support genetic testing in therapy selection. With around 15 different drug targets (e.g. genes) and genetic variation, the technology can help clinicians select the right drug and dose in a process mostly conducted together with a pathologist using lung tissue.
Schwab feels this is the most promising application, but he foresees a move towards pre-emptive testing, not only in cases of drug failure after conventional cancer therapy, but also at the onset of therapy, where genetic information will be available when prescribing. When discussing personalised laboratory medicine in genomics, he emphasises that it is important to clearly define the genome variation. Germline DNA from individuals will ease this pre-emptive approach while, in cancer patients, personalised laboratory medicine must focus on DNA from the tumour. For patients with a tumour, where Next Generation Sequencing is currently mainly conducted only in cancer relapses, he suggests that, within the next decade, this will be a routine pre-emptive pharmacogenetic test.
To Schwab, the benefits of personalised laboratory medicine are clear. ‘It’s about better treatment and selective drugs that will work if you carry a specific mutation, meaning patients will receive individualised treatment and not suffer toxicity.’ Such a medical approach promises more effective diagnostics with more effective and safer treatment, as well as faster recovery and restoration of health and improved cost effectiveness. ‘Personalised medicine in the genomics area is the future,’ he concluded, ‘but, in the next few years we will also talk about liquid biopsies because we can also use this information for epigenetic or metabolomic markers.’
Matthias Schwab is Professor and Chair of Clinical Pharmacology and heads the Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology in Stuttgart and the Department of Clinical Pharmacology, University Hospital, Tübingen, Germany. His major clinical and research activities are personalised medicine and pharmacogenomics with focus on cancer.
Source: Healthcare in Europe