title: Integrating precision cancer medicine into healthcare-policy, practice, and research challenges.
abstract: Precision medicine (PM) can be defined as a predictive, preventive, personalized, and participatory healthcare service delivery model. Recent developments in molecular biology and information technology make PM a reality today through the use of massive amounts of genetic, 'omics', clinical, environmental, and lifestyle data. With cancer being one of the most prominent public health threats in developed countries, both the research community and governments have been investing significant time, money, and efforts in precision cancer medicine (PCM). Although PCM research is extremely promising, a number of hurdles still remain on the road to an optimal integration of standardized and evidence-based use of PCM in healthcare systems. Indeed, PCM raises a number of technical, organizational, ethical, legal, social, and economic challenges that have to be taken into account in the development of an appropriate health policy framework. Here, we highlight some of the more salient issues regarding the standards needed for integration of PCM into healthcare systems, and we identify fields where more research is needed before policy can be implemented. Key challenges include, but are not limited to, the creation of new standards for the collection, analysis, and sharing of samples and data from cancer patients, and the creation of new clinical trial designs with renewed endpoints. We believe that these issues need to be addressed as a matter of priority by public health policymakers in the coming years for a better integration of PCM into healthcare.
authors: Center of Genomics and Policy, McGill University, 740 Dr. Penfield Avenue, Montreal, QC, H3A 0G1, Canada. gabrielle.bertier@mail.mcgill.ca.|Université Toulouse III Paul Sabatier and Inserm UMR 102, 37 allées Jules Guesde, F-31000, Toulouse, France. gabrielle.bertier@mail.mcgill.ca.
authors: Gabrielle
authors: 0000-0002-3319-3721
authors: G
authors: Bertier
authors: Center of Genomics and Policy, McGill University, 740 Dr. Penfield Avenue, Montreal, QC, H3A 0G1, Canada.
authors: Jian
authors: J
authors: Carrot-Zhang
authors: Sargent College, Boston University, One Silber Way, Boston, MA, 02215, USA.
authors: Vassilis
authors: V
authors: Ragoussis
authors: Center of Genomics and Policy, McGill University, 740 Dr. Penfield Avenue, Montreal, QC, H3A 0G1, Canada.
authors: Yann
authors: Y
authors: Joly
mesh_terms: D003695:Delivery of Health Care / Q000379:methods*; D019317:Evidence-Based Medicine / Q000379:methods; D023281:Genomics / Q000379:methods; D006291:Health Policy; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D008495:Medical Oncology / Q000379:methods*; D009369:Neoplasms / Q000235:genetics / Q000517:prevention & control / Q000628:therapy; D057285:Precision Medicine / Q000379:methods*; D011315:Preventive Medicine / Q000379:methods; D011634:Public Health / Q000379:methods; D015980:Public Health Practice; D049490:Systems Biology / Q000379:methods; D018511:Systems Integration; D057170:Translational Research, Biomedical / Q000379:methods
keywords: Cancer; Genomics; Health policy; Next-generation sequencing; Precision medicine; Social-economic challenges