EPMA-World Congress 2015

Abstract

Predictive preventive personalized medicine Liver cancer is the fifth most common form of cancer worldwide [1], with an incidence rate almost equals the mortality rate and ranks 3 rd among causes of cancer related death [2]. The coexistence of two life threatening conditions, cancer and liver cirrhosis makes the staging challenging. However, there are some staging systems, e.g. the Barcelona staging system for Hepatocellular carcinoma (HCC) [3], that suggest treatment options and management. Whereas diagnosis in early stages gives hope for a curative outcome, the treatment regime for around 80 % [2] of the patients classified as severe stages only gears towards palliation [4]. An intra-arterial radiation approach, radioembolisation (RE) is ubiquitously applied as one of palliative approaches. Although, in general RE shows promising results in intermediate and advanced stage HCC [5], individual treatment outcomes are currently unpredictable. Corresponding stratification criteria are still unclear. We hypothesised that individual radioresistance/radiosensitivity may play a crucial role in treatment response towards RE strongly influencing individual outcomes. Further, HCC represents a highly heterogeneous group of patients which requires patient stratification according to clear criteria for treatment algorithms to be applied individually. Multilevel diagnostic approach (MLDA) is considered helpful to set-up optimal predictive and prognostic biomarker panel for individualised application of radioembolisation. Besides comprehensive medical imaging, our MLDA includes non-invasive multi-omics and sub-cellular imaging. Individual patient profiles are expected to give a clue to targeting shifted molecular pathways, individual RE susceptibility, treatment response. Hence, a dysregulation of the detoxification pathway (SOD2/Catalase) might indicate possible adverse effects of RE, and highly increased systemic activities of matrix metalloproteinases indicate an enhanced tumour aggressiveness and provide insights into molecular mechanisms/targets. Consequently, an optimal set-up of predictive and prognostic biomarker panels may lead to the changed treatment paradigm from untargeted "treat and wait" to the cost-effective predictive, preventive and personalised approach, improving the life quality and life expectancy of HCC patients. Keywords: Market access, Value, Strategy, Companion diagnostics, Cost-effectiveness, Reimbursement, Health technology assessment, Economic models, Predictive preventive personalized medicine Achieving and sustaining seamless "drug -companion diagnostic" market access requires a sound strategy throughout a product life cycle, which enables timely creation, substantiation and communication of value to key stakeholders [1, 2]. The study aims at understanding the root-cause of market access inefficiencies of companies by gazing at the "Rx-CDx" co-development process through the prism of "value", and developing a perfect co-development scenario based on the literature review and discussions with the ...

Efficacy of nanoceria for periodontal tissues alteration in glutamate-induced obese rats—multidisciplinary considerations for personalized dentistry and prevention

“…The results of this study strongly support conclusions emphasised in our previous works [29][30][31][32][33][34]37] and are potentially applicable to create products, drugs and food supplements for treatments beneficial for individual outcomes.…”

“…The number of people with obesity was projected doubled by 2025 [1]. Obesity and metabolic syndrome has been profoundly studied by experts of the European Association for Predictive, Preventive and Personalised Medicine (EPMA) [2][3][4][5][6][7], and effective solutions by predictive, preventive and personalized medicine (PPPM) were consequently suggested considering a sensitive balance between health and disease in individuals; environmental factors in epidemics and an interplay between a genetic component, epigenetic regulations, and environmental factors [4]. In Ukraine, more than a half of the adult population is overweight, which is certainly due to the low level of physical activity, eating behavior features, increase in diet-dense foods and carbohydrate and wide and uncontrolled use of food industry and online catering food additives, especially monosodium glutamate (MSG) [8].…”

“…The results on nanoceria effects may be further considered for the vascular/microcirculation response, related to tissue microenvironment [35][36][37], that have particular importance for individuals in a suboptimal health condition such as "Flammer Syndrome" affected persons, and the strong potential for patient stratification [35] to avoid and optimally manage chronic diseases [36,37].…”

Efficacy of Fenugreek-based bionanocomposite on renal dysfunction and endogenous intoxication in high-calorie diet-induced obesity rat model—comparative study

“…Obesity and metabolic syndrome have been profoundly studied by experts of European Association for Predictive, Preventive and Personalised Medicine (EPMA) and remain the focus of frontier research [73][74][75][76]. Current paper is the follow-up of the previous works by the group [4,17,48,49,51,59,72], and it arises many essential multidisciplinary issues for obesity complications, and related conditions to be adopted in clinical set to yield safer, more effective, and expensive medical interventions with higher value [76].…”

Efficiency of dental caries prevention with the use of polymer-based toothpastes modified by the electromagnetic field

“…Background In the twenty-first century, tooth decay remains the main problem of dentistry due to the high prevalence among the world population according to the World Health Organization [1][2][3]. In connection with this, the most important tasks of modern dentistry cover not only early diagnosis but also prevention of dental caries including the one based on the use of various hygienic products and therapeutic agents [1,4].…”