Can precision medicine be integrated into routine therapeutic decisions at the bedside of patients? - 08/12/23

Doi : 10.1016/j.therap.2023.11.007

Florian Lemaitre ^a,^⁎ , Virginie Florentin ^b, Olivier Blin ^c, Arnaud Bayle ^d,^e,^{^{1
Participants of the Round Table “Pharmacology and translational research” of Giens Workshops 2023.}}, Sylvain Benito ^f,^{^{1
Participants of the Round Table “Pharmacology and translational research” of Giens Workshops 2023.}}, Jean-Vannak Chauny ^g,^{^{1
Participants of the Round Table “Pharmacology and translational research” of Giens Workshops 2023.}}, Ariane Galaup ^h,^{^{1
Participants of the Round Table “Pharmacology and translational research” of Giens Workshops 2023.}}, Daria Korchagina ^i,^{^{1
Participants of the Round Table “Pharmacology and translational research” of Giens Workshops 2023.}}, Marie Lang ^j,^{^{1
Participants of the Round Table “Pharmacology and translational research” of Giens Workshops 2023.}}, Christophe Le Tourneau ^k,^l,^m,^{^{1
Participants of the Round Table “Pharmacology and translational research” of Giens Workshops 2023.}}, Hervé Pelloux ^n,^{^{1
Participants of the Round Table “Pharmacology and translational research” of Giens Workshops 2023.}}, Nicolas Picard ^o,^{^{1
Participants of the Round Table “Pharmacology and translational research” of Giens Workshops 2023.}}, Romain Guilhaumou ^p
^a Inserm, EHESP, Irset (institut de recherche en santé, environnement et travail), UMR S 1085, CHU de Rennes, université Rennes, 35000 Rennes, France
^b Direction médecine personnalisée, Roche SAS, 92600 Boulogne-Billancourt, France
^c Inserm 1106, service de pharmacologie clinique et pharmacosurveilleance, en delegation Tafalgie Therapeutics, UMR, Aix-Marseille université, AP-HM, 13385 Marseille, France
^d Bureau biostatistique et epidémiologie, Gustave-Roussy, université Paris-Saclay, 94800 Villejuif, France
^e Inserm, CESP U1018 Oncostat, labelisé Ligue contre le cancer, université Paris-Saclay, 94800 Villejuif, France
^f ExactCure, 06000 Nice, France
^g Direction accès au marché & affaires publiques, Amgen, 92100 Boulogne-Billancourt, France
^h LEEM, 75017 Paris, France
ⁱ Illumina, 92150 Suresnes, France
^j GCS CNCR, 75014 Paris, France
^k Institut Curie, Paris, France
^l Inserm U900, Saint-Cloud, France
^m Université Paris-Saclay, 75005 Paris, France
ⁿ Parasitology-Mycology laboratory, University Grenoble-Alpes, University Hospital Grenoble-Alpes, 38043 Grenoble, France
^o Service de pharmacologie, toxicologie et pharmacovigilance, centre de biologie et de recherche en santé (CBRS), CHU de Limoges, 87042 Limoges, France
^p AP-HM, 13000 Marseille, France

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 08 December 2023
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Summary

Therapeutic strategies are shifting from a “one-size-fits-all” population-based approach to a stratified approach targeting groups with similar characteristics, or even individuals, tailoring treatments to the unique characteristics of each patient. Since such strategies rely on increasingly complex knowledge and healthcare technologies, along with an understanding of the tools of precision medicine, the appropriate dissemination and use of these strategies involves a number of challenges for the medical community. Having evaluation methodologies that have been jointly designed with the institutional, industrial, academic stakeholders, and also patients, like streamlining the processes and externally validating performances, could enhance the relevance of the “evaluation” aspect of precision medicine. Creating a network of expert precision-medicine centers and ensuring that precision-medicine procedures are reimbursed by social security would guarantee fair and sustainable access. Finally, training healthcare professionals, creating interfaces between precision-medicine expert centers and primary care professionals as well as patients, and integrating individual patient data into medical records are all key drivers that will enable information from precision-medicine to be made available and guarantee the proper use of these approaches.

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Keywords : Precision medicine, Stratification, Individualisation, Genomic, Artificial intelligence