Insights Into Breast Cancer in the East vs the West
Yoon Sim YapYen‐Shen LuKenji TamuraJoon JeongEun Young KoWinnie YeoA‐Yong CaoChing‐Hung LinMasakazu ToiJiong WuSoo Chin Lee
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During the past few decades, the incidence of breast cancer (BC) has been increasing rapidly in East Asia, and BC is currently the most common cancer in several countries. The rising incidence is likely related to changing lifestyle and environmental factors in addition to the increase in early diagnosis with BC awareness and screening. The understanding and management of BC are generally based on research and data from the West. However, emerging differences in BC epidemiology and tumor and host biology in Asian populations may be clinically relevant.A higher proportion of premenopausal BCs occur in Asia, although this factor is possibly an age-cohort effect. Although the relative frequencies of different immunohistochemical subtypes of BC may be similar between the East and West, the higher prevalence of luminal B subtypes with more frequent mutations in TP53 may be confounded by disparities in early detection. In addition, Asian BCs appear to harbor a more immune-active microenvironment than BCs in the West. The spectra of germline mutations in BC predisposition genes and single-nucleotide polymorphisms contributing to BC risk vary with ethnicity as well. Differences in tolerability of certain cytotoxic and targeted agents used in BC treatment may be associated with pharmacogenomic factors, whereas the lower body mass of the average woman in East Asia may contribute to higher toxicities from drugs administered at fixed doses. Phenotypic characteristics, such as lower breast volume, may influence the type of surgery performed in East Asian women. On the other hand, increased breast density may affect the sensitivity of mammography in detecting BCs, limiting the benefits of screening mammography.Breast cancer has become a major health problem in Asia. The inclusion of more women from Asia in clinical trials and epidemiologic and translational studies may help unravel the interethnic heterogeneity of BCs and elucidate the complex interplay between environmental and intrinsic factors in its pathogenesis. These insights may help to refine prevention, diagnosis, and management strategies for BC in the setting of ethnic diversity.Keywords:
Pharmacogenomics
As the development of the Human Genome Project (HGP), the sequencing of whole human genome has been completed, and a series of human genes have been detected, both of which result in the naissance of pharmacogenomics. Pharmacogenomics is the study of how an individuals genetic inheritance affects the bodys response to drugs using the information of human genomics and bioinformatics approaches. It is not only propitious to the rational use of drugs, but also in favor for the personalized drug design. Keywords: Pharmacogenomics, personalized use of drugs, single nucleotide polymorphisms, drug metabolism
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Pharmacogenomics is an emerging scientific discipline studying the the association between genetic polymorphisms and the individual variations in response to therapeutics. It promises to increase the safety and efficacy for drug utilization,decrease the incidence of adverse drug reactions. Pharmacogenomics provides a theoretical basis for personalized medicine. The article introduced the concept, content, methods of pharmacogenomics and its applications in establishing clinical individualized medication.
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Pharmacogenomics is a science that examines the inherited variations in genes that dictate drug response and explores the ways these variations can be used to predict whether a patient will have a good, bad, or no response at all to a drug. It refers to the general study of all of the many different genes that determine drug behavior. It could also guide companies in designing clinical trials that would more definitively prove drug efficacy, in turn decreasing the time, costs, and risks of drug development. In the clinical setting, pharmacogenomics will help physicians to better define the long-term health risks that patients face, diagnose the stage of patient’s diseases more precisely and predict patients’ responsiveness to specific drugs more accurately or the likelihood for adverse events.
Key words: Pharmacogenomics, biomarkers, gene variations
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OBJECTIVE:To introduce pharmacogenomics and its applications in establishing clinical pharmacotherapeutic schemes.METHODS:Based on the analysis of the related literatures,the development and contents of pharmacogenomics and their relationship with individualized medication were summarized.RESULTS:Pharmacogenomics studies the association between gene polymorphisms and the variance of drug effects.CONCLUSION:Pharmacogenomics provides a theoretical basis for medication with safety,effectiveness and rationality.
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This chapter contains sections titled: Pharmacogenetics – The Roots of Pharmacogenomis Pharmacogenomics – It is Not just Pharmacogenetics Genetic Drug Response Profiles The Effect of Drugs on Gene Expression Pharmacogenomics in Drug Discovery and Drug Development Pharmacogenomics – Hope or Hype?
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With the completion of the human genome project, pharmacogenomics is regarded as part of genomic medicine and personalized medicine. While pharmacogenomics is concerned with the whole genome effect on drug metabolism and efficacy, pharmacogenetics is readily defined as the study of the genetic effect, for example, single-nucleotide polymorphism, on an individual's ability to metabolize a drug or compound. Pharmacogenomic biomarkers, in combination with other biomarkers, enable personalized medicine by identifying the right patient, with the right diagnosis/treatment, matching with the right drug, the right dose and at the right time, thus achieving clinical efficacy with no or minimized toxicity. This chapter would attempt to present pharmacogenomics, not only as an emerging, inter-dependent discipline, but as a complementing field in enhancing drug therapy. It includes the introduction, the pharmacogenomics space and the enabling drivers, the principles of pharmacogenetics/pharmacogenomics, with update on the candidate pharmacogenomics testing. Recent examples would include warfarin and irinotecan, showing that pharmacogenomic biomarkers would serve as adjuncts to other functional biomarkers for enhanced drug therapy.
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To know the real incidence of tuberculosis in Galicia and its epidemiological characteristics.Study of data recorded in the "Galician Programme for Tuberculosis Control and Prevention", where an active epidemiological survey of every diagnosis of tuberculosis is carried out in every part of Galicia.1995 cases were included in this study, with an incidence of 72.7/100,000 inhabitants. 58% of the cases were detected by the epidemiological survey. 92% of the cases were newly diagnosed cases, being the remain relapses. The highest incidence were localized in the areas of A Coruña and Vigo. The mean age was 40.5 years with 57% being between 15 and 44 years. Male incidence was 92.8/100,000 and female incidence was 54.0/100,000 (RR = 1.72; CI 95%: 1.57-1.88). 18.1% of the patients had at least one of the following risk factors associated: HIV infection (9.1%), alcoholism (8.4%) or injecting drug use (7.3%). Other risk factors for tuberculosis were very unusual. Pulmonary localization was the most frequent form with 1389 cases (incidence: 50.6/100,000). 742 patients were considered to be bacilliferous (incidence: 27/100,000).The incidence of tuberculosis in Galicia is high. Its epidemiological characteristics suggest a historical lack of measures of tuberculosis control.
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Pharmacogenomics is the study of the contribution of inheritance to variation in drug response—variation that can range from a loss of the desired therapeutic effect at one end of the spectrum to an adverse drug reaction at the other (1,2). The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recently sponsored a workshop on the pharmacogenomics of metformin, the most widely prescribed drug for the treatment of type 2 diabetes. Metformin displays wide variation in efficacy and occasional serious adverse reactions (3). A report of that workshop is published in this issue (4). Pawlyk et al. (4) provide an overview of the current status of metformin pharmacogenomics as well as insight into the current state of pharmacogenomics as a discipline. Pharmacogenomic information is increasingly being implemented clinically and is being used to adjust drug dosage or to avoid adverse drug reactions (5). At the same time, pharmacogenomic research has moved from a focus on the contribution of genetics to variation in processes that we already understand—for example, drug metabolism and known drug target(s)—to also become a …
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