Personalized Medicine in Kidney Cancer: Learning How to Walk Before We Run

Yousef, George M.

doi:10.1016/j.eururo.2015.06.037

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…More recently, ongoing advances in immunohistochemistry and molecular analysis have further refined the job of the pathologist to provide additional prognostic and predictive information . Another revolutionary milestone came recently with the introduction of concepts of precision medicine and P4 medicine, which is defined as being predictive, preventive, personalized, and participatory (based on active patient participation) …”

Section: The Evolving Role Of the Pathologist In Precision Medicinementioning

confidence: 99%

Translational research: Empowering the role of pathologists and cytopathologists

Khella

Yousef

2018

Cancer Cytopathology

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Research activity is in the core essence of pathology. Advancing our understanding of disease pathogenesis translates into better patient care. Because of their unique position, laboratorians are the best to accurately identify, annotate, and classify research specimens. They also are essential for the accurate interpretation of genomic testing. Currently, cytopathologists are moving to the center of patient care through active communication with clinicians and patients. There are certain research areas in which cytopathologists can be pioneers, such as image analysis, morphology research, and genotype-phenotype association studies integrating morphologic and molecular features. Health service utilization research is another domain in which cytopathologists can excel. Successful research is a journey that necessitates multiple steps. It also involves building expertise in how to overcome obstacles and handle challenges. Cancer Cytopathol 2018;126:831-838. Commentary 832 Cancer Cytopathology October 2018Although they hold out hope of a significantly improved patient outcome by individualizing a treatment plan based on tumor biology, these new concepts carry a great challenge to the standard-of-care paradigms 6-9 and represent dramatic, revolutionary changes in the role of the cytopathologist. Molecular tests done for patients with different types of diseases are performed in the laboratory. The indication, interpretation, and clinical significance of a molecular test usually require active communication between laboratory team, clinicians, and patients. Consequently, the role of the cytopathologist's role is moving toward the center of patients' circle of care and becoming an active participant in multidisciplinary management teams that include clinicians, biologists, and pathologists, with input from patients. 10 The exponential growth in companion testing with molecular diagnostics has elicited discussion about the need to develop an integrated morphomolecular pathology specialty in which pathologists are equipped with combined molecular and morphologic expertise, enabling them to address the challenge of genomic medicine. 11 RESEARCH IN PATHOLOGYAn important question is why pathologists should be involved in research. There are several factors that necessitate the involvement of pathologists in research, and the advantages of getting pathologists involved in research include the following:

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Section: The Evolving Role Of the Pathologist In Precision Medicinementioning

confidence: 99%

Translational research: Empowering the role of pathologists and cytopathologists

Khella

Yousef

2018

Cancer Cytopathology

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“…However, after the era of human genome project [12], we are currently moving fast into the age of molecular profiling of cancer genomics [13], bioinformatics [14], precision medicine [15] and digital imaging that generate a wealth of "raw data" through highthroughput experimental and analytical platforms. These new advances in research tools though needed, are very complex and expanding, which sometimes makes them difficult to interpret, envision or properly utilize [16,17]. The hope for better understanding and clinical utilization of these new tools comes through the integration of different data types [18,19].…”

Section: Introductionmentioning

confidence: 99%

Histo-genomics: digital pathology at the forefront of precision medicine

et al. 2018

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The toughest challenge OMICs face is that they provide extremely high molecular resolution but poor spatial information. Understanding the cellular/histological context of the overwhelming genetic data is critical for a full understanding of the clinical behavior of a malignant tumor. Digital pathology can add an extra layer of information to help visualize in a spatial and microenvironmental context the molecular information of cancer. Thus, histo-genomics provide a unique chance for data integration. In the era of a precision medicine, a four-dimensional (4D) (temporal/spatial) analysis of cancer aided by digital pathology can be a critical step to understand the evolution/progression of different cancers and consequently tailor individual treatment plans. For instance, the integration of molecular biomarkers expression into a three-dimensional (3D) image of a digitally scanned tumor can offer a better understanding of its subtype, behavior, host immune response and prognosis. Using advanced digital image analysis, a larger spectrum of parameters can be analyzed as potential predictors of clinical behavior. Correlation between morphological features and host immune response can be also performed with therapeutic implications. Radio-histomics, or the interface of radiological images and histology is another emerging exciting field which encompasses the integration of radiological imaging with digital pathological images, genomics, and clinical data to portray a more holistic approach to understating and treating disease. These advances in digital slide scanning are not without technical challenges, which will be addressed carefully in this review with quick peek at its future.

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“…Although these initiatives represent valuable steps toward understanding the underlying biology of diseases, thereby improving health care, there are a number of issues that have to be addressed carefully so that we do not give false hope to the public [6], as outlined below.…”

Section: Introductionmentioning

confidence: 99%