The future belongs to personalized medicine – Corriere.it

From Health editorial team

Thanks to the identification of precise molecular modifications, it is possible to identify the population groups most at risk of developing cancer and to select more effective therapies

Not just genes or molecular targets, to be targeted with targeted anti-cancer therapies. Today’s exact oncology goes far beyond this horizon, to include a much broader universe. Cancer prevention becomes personal thanks to the identification of precise molecular modifications that allow identification of populations at risk. In therapeutics, the mutational model to be followed, in which all changes experienced by the organism are followed, as a result of changes in the individual and external environment, which may have a role in the development of cancer and in the choice of treatment, must be taken into account. The new frontiers were defined today in Rome at the University of La Sapienza at the Regional Meeting of the World Health Summit – Europe, at the session devoted to precision oncology moderated by Paolo Marchetti, Scientific Director IDI IRCCS in Rome, Professor of Oncology at La University. Sapienza de Roma and Chair of the Foundation for Personalized Medicine, and Khai Guan Yeh, Professor of Medicine at the University of Singapore.

personal protection

The purpose of the meeting, which is part of the Global Health Summit held every year at the end of October in Berlin, is to study innovative elements and recommendations that will be made to assess the political and academic authorities to overcome the inequalities that still exist. It is present in health systems and access to treatments. Prevention becomes personal because it can build on precision medicine models, by identifying specific genomic determinants associated with increased cancer risk, says Marchetti. This includes a series of interventions to identify the tumor at an early stage or to avoid the onset of the disease. For example, women with a mutation in the BRCA gene, a risk factor for breast cancer, may be offered more frequent breast screening programs, which are part of secondary prevention, or treatment with aromatase inhibitors or anti-estrogens. Still in clinical trials, To enhance primary prevention. Thus we can save more lives and ensure savings for the health system. These issues regarding personal prevention were articulated at the meeting by Stefania Bocchia, Professor of Hygiene, Preventive Medicine and Public Health at the Catholic University of the Sacred Heart in Rome.

Mutational model

Molecular pathology is the cornerstone of precision oncology – Marchetti continues -. A genetic mutation can no longer be a solution to the problem. It is essential to learn to study not only individual modifications but overall modifications of cellular signaling pathways. Thus the molecular pathologist can provide the clinician with information critical to the choice of treatment. For example, a patient with a high mutational burden, theoretically a candidate for immunotherapy, should be referred for another treatment if there is a mutation that prevents response to immunotherapy. The so-called histological model has long governed clinical research in oncology, regulatory decisions, and clinical practice – Marchetti concludes -. In this approach, the starting point is the organ from which the disease arose, followed by histological examination, identification of any molecular changes and drug selection, through the pathway of selecting patients with the greatest likelihood of responding. treatment or treatment. The histological model has been replaced by the agnostic model, in which tumor therapies are selected independently of the tumor site on the basis of specific genetic alterations or specific molecular aspects present in different tumors, which represent the cellular target. Today, the new paradigm is the “mutational” paradigm in which all changes that an organism goes through must be taken into account, including also the microorganisms, the group of billions of microorganisms that live in the body and provide essential support for our life.

Jun 19 2022 (change on Jun 19, 2022 | 19:35)

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