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E-raamat: Biomarker Tests for Molecularly Targeted Therapies: Key to Unlocking Precision Medicine

  • Formaat: 292 pages
  • Ilmumisaeg: 30-Jun-2016
  • Kirjastus: National Academies Press
  • Keel: eng
  • ISBN-13: 9780309381352
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  • Formaat: 292 pages
  • Ilmumisaeg: 30-Jun-2016
  • Kirjastus: National Academies Press
  • Keel: eng
  • ISBN-13: 9780309381352
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Every patient is unique, and the evolving field of precision medicine aims to ensure the delivery of the right treatment to the right patient at the right time. In an era of rapid advances in biomedicine and enhanced understanding of the genetic basis of disease, health care providers increasingly have access to advanced technologies that may identify molecular variations specific to an individual patient, which subsequently can be targeted for treatment. Known as biomarker tests for molecularly targeted therapies, these complex tests have the potential to enable the selection of the most beneficial treatment (and also to identify treatments that may be harmful or ineffective) for the molecular underpinnings of an individual patient's disease. Such tests are key to unlocking the promise of precision medicine.





Biomarker tests for molecularly targeted therapies represent a crucial area of focus for developing methods that could later be applicable to other areas of precision medicine. The appropriate regulatory oversight of these tests is required to ensure that they are accurate, reliable, properly validated, and appropriately implemented in clinical practice. Moreover, common evidentiary standards for assessing the beneficial impact of biomarker-guided therapy selection on patient outcomes, as well as the effective collection and sharing of information related to those outcomes, are urgently needed to better inform clinical decision making.







Biomarker Tests of Molecularly Targeted Therapies examines opportunities for and challenges to the use of biomarker tests to select optimal therapy and offers recommendations to accelerate progress in this field. This report explores regulatory issues, reimbursement issues, and clinical practice issues related to the clinical development and use of biomarker tests for targeting therapies to patients. Properly validated, appropriately implemented biomarker tests hold the potential to enhance patient care and improve outcomes, and therefore addressing the challenges facing such tests is critical.



Table of Contents



Front Matter Summary 1 Introduction 2 Envisioning a Rapid Learning System for Biomarker Tests for Molecularly Targeted Therapies 3 Supportive Policy Environment for Biomarker Tests for Molecularly Targeted Therapies 4 Supporting Data Infrastructure for Biomarker Tests for Molecularly Targeted Therapies 5 Processes to Improve Patient Care Appendix A: Committee Member and Staff Biographies Appendix B: Coding: Payment Infrastructure for Biomarker Tests for Molecularly Targeted Therapies Appendix C: Information-Gathering Sessions and Speakers Glossary
Acronyms xix
Summary 1(22)
1 Introduction
23(24)
Biomarker Tests
24(4)
Precision Medicine
28(6)
Study Scope
34(3)
Context of the Study
37(2)
Methods of the Study
39(2)
Organization of the Report
41(1)
References
42(5)
2 Envisioning A Rapid Learning System for Biomarker Tests for Molecularly Targeted Therapies
47(22)
Learning Health Care System
48(3)
Examples of Learning Health Care Systems
51(6)
A Rapid Learning System for Biomarker Tests for Molecularly Targeted Therapies
57(9)
References
66(3)
3 Supportive Policy Environment for Biomarker Tests for Molecularly Targeted Therapies
69(74)
Evidentiary Standards of Clinical Utility
71(9)
Regulatory Challenges
80(11)
Reimbursement Challenges
91(14)
Creating a Supportive Policy Environment for Biomarker Tests for Molecularly Targeted Therapies
105(25)
Summary and Recommendations
130(4)
References
134(9)
4 Supporting Data Infrastructure for Biomarker Tests for Molecularly Targeted Therapies
143(40)
Electronic Health Records
144(14)
Big Data
158(13)
Summary and Recommendations
171(3)
References
174(9)
5 Processes to Improve Patient Care
183(44)
Current Challenges in Test Result Interpretation
184(5)
Equity in Access to Testing and Expertise
189(13)
Specimen Acquisition and Quality
202(4)
Clinical Practice Guidelines
206(5)
Summary and Recommendations
211(3)
References
214(13)
APPENDIXES
A Committee Member and Staff Biographies
227(14)
B Coding: Payment Infrastructure for Biomarker Tests for Molecularly Targeted Therapies
241(8)
C Information-Gathering Sessions and Speakers
249(4)
Glossary 253