Stratified medicine in inflammatory disorders: From theory to practice.
Chronic inflammatory disorders are complex and characterized by significant heterogeneity in molecular, pathological, and clinical features. This heterogeneity poses challenges for the development of targeted molecular interventions for these disorders, as not all patients with a given clinical diagnosis have disease driven by a single dominant molecular pathway, hence not all patients will benefit equally from a given intervention. Biomarkers related to molecular manifestations of disease are increasingly being applied to enable stratified approaches to drug development. Biomarkers may be used to identify which patients are most likely to benefit from an intervention (predictive), identify patients at increased risk of disease progression (prognostic), and monitor biological responsiveness to an intervention (pharmacodynamic). Here we consider how biomarker-guided stratification of patients may increase benefit from targeted therapies for asthma, rheumatoid arthritis and inflammatory bowel diseases.
Department of Immunology Diagnostic Discovery, Genentech, Inc., One DNA Way, South San Francisco, CA 94080, USA. Electronic address: arron.joseph@gene.com.
Joseph R
JR
Arron
Department of Immunology Diagnostic Discovery, Genentech, Inc., One DNA Way, South San Francisco, CA 94080, USA.
Michael J
MJ
Townsend
Department of Immunology Diagnostic Discovery, Genentech, Inc., One DNA Way, South San Francisco, CA 94080, USA.
Mary E
ME
Keir
Department of Human Genetics, Genentech, Inc., One DNA Way, South San Francisco, CA 94080, USA.
Brian L
BL
Yaspan
Department of Immunology, Genentech, Inc., One DNA Way, South San Francisco, CA 94080, USA. Electronic address: acc@gene.com.
Andrew C
AC
Chan
D000068879:Adalimumab / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D058990:Molecular Targeted Therapy / Q000379:methods; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D015415:Biomarkers; D000068879:Adalimumab
Asthma; Biomarker; Rheumatoid arthritis; Ulcerative colitis