Personalized Medicine and Cardio-Oncology

Cardiotoxicity is a well-established complication of oncology therapies. Cardiomyopathy resulting from anthracyclines is a classic example. In the past decade, an explosion of novel cancer therapies, often targeted and more specific than conventional therapies, has revolutionized oncology therapy and dramatically changed cancer prognosis. However, some of these therapies have introduced an assortment of cardiovascular (CV) complications. At times, these devastating outcomes have only become apparent after drug approval and have limited the use of potent therapies. There is a growing need for better testing platforms, both for CV toxicity screening and for elucidating mechanisms of cardiotoxicities of approved cancer therapies. This review discusses the utility of available nonclinical models (in vitro, in vivo, and in silico) and highlights recent advancements in modalities like human stem cell-derived cardio-myocytes for developing more comprehensive cardiotoxicity testing and new means of cardio-protection with targeted anticancer therapies.The ability to generate patient-specific PLURIPOTENT STEM CELL-DERIVEDs creates the opportunity for a personalized approach to characterizing drug-induced toxicities. This personalized PLURIPOTENT STEM CELL-DERIVED approach parallels pharmacogenomics efforts to understand the role of genetics in individual patient drug responses. Because patient derived PLURIPOTENT STEM CELL-DERIVEDs possess the patient-specific genetic variations, cardiotoxicity testing in these cells may allow for in vitro evaluation of drug efficacy or safety for a particular individual. Sex and ethnic differences of cancer drug efficacy and safety have been well documented, and use of patient-derived PLURIPOTENT STEM CELL-DERIVEDs may enable assessment of the genetic and molecular basis sex- and ethnicity-based variable effects. In proof-of-principle investigations, PLURIPOTENT STEM CELL-DERIVED studies detected the cardiotoxicity of drugs that are arrhythmogenic. One important study demonstrated that PLURIPOTENT STEM CELL-DERIVEDs from diseased individuals with long QT syndrome, hypertrophic cardiomyopathy, or dilated cardiomyopathy are more susceptible to known cardiotoxic drugs than those cells of healthy patients. …….

کلیدواژه ها:

Personalized Medicine ، Cardio-oncology ، PLURIPOTENT STEM CELL-DERIVED ، Cardiotoxicity