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A New Challenge to Personalized Cancer Treatment: Information Explosion

چالشی جدید پیش روی درمان شخصی‌سازی شده سرطان: انفجار اطلاعات

A flood of information is sent daily to cancer clinics. Oncologists are trying to find new ways to extract the best modern cancer treatment from this information.

We are on the threshold of the era of personalized medicine. During this period, each person’s cancer treatment is customized according to their genetic makeup. By genome testing, it is possible to record the genetic information of cancers and identify specific mutations that have led to each individual’s tumors. Clinical studies are exploring new drugs or finding new applications for existing drugs.

In theory, these findings should enable oncologists to find specific treatments for each type of cancer that will provide better outcomes for patients. But in practice, oncologists are faced with an eruption of information that cannot be processed. As a result, cancer treatments are often not as personal as they should be.

Challenge of oncologists

It is possible to obtain the genetic and molecular details of each patient’s cancer specifically; Information that can contain life-saving clues. But the problem is that we can not always know which molecular diagnostic test is right for the patient.

When we obtain genetic sequencing data, it is often unclear what implications this data may have for the patient’s treatment process. Despite research pointing to different uses for drugs, choosing the most effective drug is difficult. For example, the efficacy of several anaplastic lymphoma kinase (ALK) inhibitors in the treatment of lymphoma, non-small cell lung cancer (NSCLC), and neuroblastoma has been demonstrated, while other findings suggest that one of these inhibitors may be effective in treating cancer. be useful.

In addition, some patients face challenges in accessing genetic sequencing and determining the exact treatment for their disease. Some health insurances do not cover genetic testing, or pay much lower than the test price. Other insurers are also reluctant to pay for drugs outside of their usual use.

According to a recent study by the Hackensack Meridian Health Organization, oncologists in this community who treated patients with non-small cell lung cancer had difficulty handling tumor specimens and faced long waiting times for laboratory tests. And their access to targeted therapies was limited. Another difficulty is that new generation sequencing results are often presented in pdf format, which cannot be digitally integrated with other patient records.

Although science and precision medicine are advancing rapidly, oncologists cannot keep up with these advances.

Updates are much faster than oncologists can read them all, or learn them all at an annual conference. It is easy to say that new sources are far beyond what an oncologist can analyze, interpret, and apply, especially given a cancer doctor’s daily schedule of visiting patients, managing relevant clinical documentation, Office work and paperwork are insurance.

Genomics available

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In the face of these massive challenges, oncologists must have strong support for achieving optimal cancer treatment, and now they are gradually gaining that support. This support can help them access, understand, and use new data to improve their patients’ treatment.

A new case of a critically ill cancer patient at the John Theurer Cancer Center in Hacksen Meridian helps to better explain the program. This patient had two separate biopsies. Each of the tests had a different result, and one of them diagnosed an incurable type of cancer. But the patient’s genetic sequencing revealed a mutation that turned out to be a very easy cancer to treat. The patient was treated with a scientifically proven chemotherapy and soon showed signs of recovery.

To ensure that patients have access to treatment based on genomic analysis, the Hanksen Meridian organization and a partner organization, the Genomic Testing Cooperative, have set up a home genomic registration center. They test 434 genes for solid tumors and find DNA and RNA mutations and chromosomal structural abnormalities. For leukemia, the center produces a hematology profile consisting of 177 genes.

Hankson Meridian specialists are also building a database that links genetic results, types of cancer, cancer drugs, and treatment outcomes to patients; Hoping that oncologists can quickly analyze a patient’s cancer and use this information to improve his treatment. Other major cancer centers are working on similar projects.

Automatic specialization

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The next step is to use artificial intelligence to search the data – genomics, drugs tested, population and patient outcome, and scientific research – and then provide clinical advice. This system is known as clinical decision support (CDS). IBM Watson was designed to do just that, but it could not do it. Other tech companies are developing their own cancer treatment software. Within a decade, we could have a CDS system that revolutionized cancer treatment.

Finally, a CDS system integrates clinical data with the National Comprehensive Cancer Network Guidelines – a set of evidence-based recommendations to assist treatment professionals in the prevention, diagnosis and treatment of cancer. The system also collects patients’ personal information and automatically sends it to insurance companies for approval. This relieves doctors of a large administrative burden.

Currently, however, oncologists can get the best guidance from discussing with interdisciplinary specialists – radiologists, pathologists, oncologists, oncologists, and surgeons – known as molecular tumor boards. They review cases, review available data, and make treatment recommendations. Such a group of specialists, who analyze molecular test data and clinical tables of patients and compare them with research data, is very useful for oncologists, especially those working in local and small communities.

To use the full potential of technology-based therapies, committed therapists are always needed. Compassionate physicians, nurses, nutritionists, and social workers must see each patient as an individual who has not only physical but also mental, psychological, and social needs. Cancer patients are best able to cope when they have a healthy diet, regular physical activity, a positive mental attitude, and adequate social support.

This holistic approach, combined with targeted cancer therapies, has become the basis of personalized medicine, which will have tremendous effects on cancer treatment in the future.

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