Role of proteomics in personalized medicine

Vignette 1: current practice A 45-year-old female presents at a clinic with a complaint of shortness of breath. After a thorough cardiovascular evaluation that reveals no evidence of heart disease, a computed tomography (CT) scan of the thorax reveals several large nodules in the right lung. An endoscopically-obtained tissue biopsy is taken and fixed in formalin for morphological analysis by a pathologist. Under a microscope, the pathologist examines the tissue section that has been stained with hematoxylin and eosin. Based on experience, the pathologist classifies the tissue as a poorly differentiated adenocarcinoma of the lung. A subsequent staging imaging study is performed revealing likely significant nodal involvement. Based on years of clinical correlations and clinical trials, this patient begins a treatment regimen including chemotherapy. The oncologist communicates to the patient that a range of patient responses to the proposed chemotherapies has been observed, from good to poor response. Patient concerns over the side effects of therapy are balanced against the hope of a good response. At present, based on morphological assessments, the type of response cannot be predicted.