Anti-Neoplastics #4 Flashcards
Define personalized or precision medicine.
Separates patients into different groups with medical decisions, practices, interventions
being tailored to the individual patient based on their predicted response or risk for disease
Why is diagnostic testing used in precision medicine?
In PM, diagnostic testing is employed for selecting appropriate or optimal therapies based on the context of a patient’s genetic content or other molecular or cellular analysis. Enzymes especially b/c?
What is the benefit of analyzing a patient’s genes in the field of precision medicine?
In PM, by analyzing patient’s genes, you can identify certain drugs that may be dangerous/toxic or completely ineffective
How can you identify mutations linked to specific diseases?
To identify mutations linked to certain disease, GWASs (genome-wide association study) are performed: sequencing the genome of many patients in the particular disease
Define pharmacogenetics.
Pharmacogenetics is the study of genetic causes of individual variations in DRUG RESPONSE
Define pharmacogenomics.
Pharmacogenomics: is the study of the role of the genome in DRUG RESPONSE
What is targeted therapy?
Targeted Therapy: targeting specific molecules and/or signaling pathways
Essential part of precision medicine
Precision medicine was further advanced by?
Advances in DNA sequencing technology and Human Genome Project (1990 -2003)
International HapMap Project (2002 -2010): identification of genetic variations that contribute to human disease (s)
Previous observations that were not fully understood.
Observations:
➢ Certain drugs are more effective in some patients and others
➢ In response to certain drugs, some patients experience unusually severe side effects
Progress in understanding the molecular factors responsible for differences in drug response became possible by developing two new fields in pharmacology: Pharmacogenetics and Pharmacogenomics
What is the importance of health information technology?
Health Information Technology (Electronic Health Records: history, family history, medications, test results, demographics)
What are some of the challenges in achieving more personalized medicine?
Challenges: >106 variation, multiple disciplines analysis, geographic and ethnic differences, ethical problems
What does inter-patient variability in drug response result from?
Interpatient variability in drug response may result primarily from genetically determined differences in drug metabolism, drug distribution, and drug target proteins
What is the long term goal of both pharmacogenetics and pharmacogenomics?
Long-term goal: to help doctors select the drugs and doses best suited for each person
Is personalized medicine used in veterinary medicine?
- Personalized medicine, which has seen success in humans, is now flourishing in veterinary medicine
- Conditions from canine cancers to drug and anesthesia sensitivity are being studied in new ways
- The AKC CHF is focusing on personalized medicine to unlock new treatment methods
What is the benefit of conducting genetic testing in dogs?
Genetic testing reveals which targeted therapies might work. The information provided by genomic testing in conjunction with tumor type helps to identify possible cancer-causing mutations and then suggests targeted therapy to precisely attack the cancer cells.
What is the significance of MDR1?
MDR1 gene: the single most “Very Important Pharmacogene (VIP) in dogs
MDR-1 gene mutations produces a?
Mutations results in a non-functional P-glycoprotein transporter protein
MDR-1 gene mutation results in ?
A decrease in function alters the safety and efficacy of drugs in affected patients
Dogs suffering from the MDR-1 gene mutation demonstrate what clinical signs?
Affected dogs show extreme sensitivity (toxicity) to Vincristine and Doxorubicin
Is testing for the MDR-1 gene mutation common?
▪ It is a standard practice in Vet Med to test for the MDR mutation prior to using P-glycoprotein transported drugs in dogs
What dog breeds are most likely to suffer from the MDR-1 gene mutation?
Shetland sheepdogs (Shelties), Australian shepherds, old English sheepdogs, English shepherds, German shepherds, long-haired whippets, silken windhounds, Collies, Waller