实施精准医学的机遇与挑战

美国总统奥巴马2015年初提出"精准医学"项目。随着对"精准医学"解读的逐步深入,精准医学在临床科研领域的内涵不断完善,现有的知识体系与个体化整合,对医学的认知得以从时间-空间-对象三个维度拓展。近年来,基因技术推动了肿瘤治疗的进步,基因及分子分型让我们对肿瘤有了全新的理解,靶向药物的应用开启了肿瘤治疗的新时代。然而,我们不得不承认很多恶性肿瘤(胰腺癌,肝癌,肺癌等)患者的生存仍很不乐观。精准医学理念带来了疾病分类体系的变革,也为疑难杂症和特殊遗传病的诊治带来曙光,测序及基因分析提供了大量数据和信息,促进了新药的研发和应用。同时我们也应该认识到,现阶段精准医学的实践面临诸多挑战,现行的指南和规范都是基于人群的数据,而在个体化基础上的精准医学还有很长的路要走。

Implementation of "Precision Medicine": opportunities and challenges

At the beginning of the 2015, US president Obama launched the program of "Precision Medicine". Interpretation of "Precision Medicine" provided better understanding of diseases by combining present structure of medicine and the concept of individualization, leading to the expansion of knowledge through three dimensions: time-space-subject. Recently, gene technology pushed the treatment of cancer forward, gene as well as molecular typing resulted in entirely new comprehension of cancer, and target drug opened a new era of cancer treatment. Until now, however, the overall survival of malignancies (eg. carcinoma of pancreas, liver and lung) remains. "Precision Medicine" brought in revolution of disease classification system, and diagnosis of certain rare or inherited diseases. Huge amount of data were supplied by gene sequencing, which improve the research and application of new drug. With these advances, the clinical application of "Precision Medicine" still confronts numerous challenges, nearly all current guidelines are based on population data rather than personalized characteristics. With the integration of past and present, there is a long way to go for "Precision Medicine".