COSA 2015* Is personalised medicine delivering on the promise of reduced drug-related harm (#116)
Personalised medicine is about targeting the delivery of the cancer therapy to the individual patient to encompass the person’s unique clinical, genetic, social and cultural profile.
Despite the advances with the use of newer targeted therapies we still rely on the use of cytotoxic cancer therapies to treat cancer, either on their own, or in combination with the biological therapies. Chemotherapy is a broad acting therapy - it not only targets cancer cells it also harms normal cells causing acute effects during treatment and in some cases causing longer lasting harm. Tailoring cancer therapy to an individual is a strategy to maximise tumour kill while minimising harmful effects of therapy. Traditionally cancer chemotherapy has been ‘personalised’ by using combinations of chemotherapies that the persons tumour is highly likely to respond to while dosing according to a person’s height, weight and organ function. Targeted therapies may also be tailored, not only according to tumor markers, but also according to a person’s weight/body surface area, organ function and toxicities. These therapies also have a spectrum of side effects with the potential to cause harm.
Complex protocols have now emerged for combinations of chemotherapy and targeted therapy with intricate requirements for dosing and scheduling with the addition of supportive therapy to minimise side effects. The complexity of many protocols potentiates the possibility to cause accidental harm due to the many steps involved in ensuring the correct drug at the correct dose is delivered to the patient at the correct time.
This session will discuss how personalised therapy still has the potential to cause harm for our patient with cancer and strategies that can be implemented in clinical practice to reduce harm.
