转化医学和个体化医学.ppt

Current State of Translational Medicine 17 year innovation adoption curve from discovery into accepted standards of practice Even if a standard is accepted, patients have a 50:50 chance of receiving appropriate care, a 5-10% probability of incurring a preventable, anticipatable adverse event The market is balking at healthcare inflation, new diagnostics and therapeutics will find increasing resistance for reimbursement Personalized Medicine Clinic Lab Population T1 T2 T1:applying basic science findings from lab research in clinical studies of patients T2:applying the findings of clinical studies to alter health practices in the community EBM Tranaslational Medicine Personalized Medicine Personalized medicine the application of genomic and molecular data to better target the delivery of health care, facilitate the discovery and clinical testing of new products, and help determine a persons predisposition to a particular disease or condition a patients protein, gene or metabolite profile could be used to tailor medical care to that individuals needs Imatinib for GIST GIST genesis Key process： c-kit mutation---KIT TK activation PDGFR mutation 86% GIST kit mutation，prognosis factor Imatinib Oral small molecule TKI Inhibit TK activation抑制酪氨酸激酶活化 Design for chronic myeloid leukemia (CML) Imatinib for GIST Imatinib for GIST Joensuu H，et al. 2001 Pretreatment One month of therapy HE (at diagnosis) HE Ki 67 CD117 Joensuu H et al. N Engl J Med. 2001;344:1052-1056. The First GIST Patient: Histology Imatinib for GIST Imatinib for GIST Joensuu H，et al. 2001 Theory：Imatinib could target GIST Easy Detected tumor marker：CD117 Tissue from the patient Response confirmed by pathology Dynamic monitored by tumor marker Ethics： IRB Imatinib 治疗 GIST 2000.3： Joensuu H. first case 2000.7： phase II study(B2222) 2001 autumn：phase II study (S0033,EORTC) 2002.2：FDA Imatinib for GIST 5-year survival Kit mutation predict Imatinib response Imatinib for GIST Imatinib for GIST Imatini