Cancer Phenotype Diagnosis and Drug Efficacy within Japanese Health Care

Abstract

An overview on targeted personalized medicine is given describing the developments in Japan of lung cancer patients. These new targeted therapies with novel personalized medicine drugs require new implementations, in order to follow and monitor drug efficacy and outcome. Examples from IRESSA (Gefitinib) and TARCEVA (Erlotinib) treatments used in medication of lung cancer patients are presented. Lung cancer is one of the most common causes of cancer mortality in the world. The importance of both the quantification of disease progression, where diagnostic-related biomarkers are being implemented, in addition to the actual measurement of disease-specific mechanisms relating to pathway signalling activation of disease-progressive protein targets is summarised. An outline is also presented, describing changes and adaptations in Japan, meeting the rising costs and challenges. Today, urgent implementation of programs to address these needs has led to a rebuilding of the entire approach of medical evaluation and clinical care.

Figure 1

Chemical drug structure of Gefitinib, as a freebase (a) and Erlotinib as a (HCl) salt (b), respectively.

Figure 2

Publication frequency during the past 10 years using the keyword “clinical biomarker” in search of ISI Web of Knowledge on April 29, 2011.

Figure 3

Diagnostic testing linked to targeted personalized drug treatment of lung cancer patients.

Figure 4

Mass spectra on the sequence identity of (a) Stathmin and (b) major vault protein (MVP) that was found differentially regulated in the LCNEC patient tissues.

Figure 5

Immunohistochemical staining of LCNEC tissue for (a) Stathmin and (b) for major vault protein (MVP).

Figure 6

Enlarged region of a squamous cell lung tumor section with MALDI-MS read out of the Erlotinib fragment ion (m/z  336.19) and HE stained histological details. Typical areas of tumor cells are indicated with yellow-dashed lines.