Teresa Marafioti "Precision Cancer Medicine: from Biomarkers Discovery to Clinical Application of Multiplex Immunolabelling technique" - 22 novembre 2018 ore 17.00

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Teresa Marafioti, MD, FRCPath, Professor of Haematopathology, NHS Consultant Histopathologist and Service Lead of Haematopathology, Department of Histopathology, University College Hospitals London, UK

"Precision Cancer Medicine: from Biomarkers Discovery to Clinical Application of Multiplex Immunolabelling technique"

Diseases were classified in the past by what could be seen and/or felt. About a century ago, we began to define them anatomically, physiologically and biochemically and more recently by applying molecular and genetic techniques.

It has been demonstrated that most human diseases and cancers in particular are complex and their aetiology includes many genetic pathways. A given type of cancer is characterised by a specific phenotype which is dictated by alterations of multiple potential genes that are affected by genomic and/or epigenetic changes. These include mutations, copy number variations, epigenetic modifications, etc. However, advances in molecular medicine have demonstrated that different individuals with the same disease phenotype may have different causal genes and therefore need different drug targets. This is the basis for the development of precision medicine and the use of truly individualised treatment strategies i.e. the ‘right drug’ for the ‘right patient’ at the ‘right time’.

Analysis series of clinical, pathological and molecular data have led to the identification of biomarkers that can detect subgroups of patients with distinct disease mechanisms, to predict clinical outcomes, predict drug response or resistance and facilitate tailoring treatment to an individual person’s disease.

Delivery of biomarker-directed precision requires involvement of a broad range of health care professionals including pathologists, surgeons, clinicians, radiologists, immunologists, geneticists, medical oncologists and bioinformatic specialists.

The emergence of new therapeutic approaches such as immunotherapy has revealed that interdisciplinary communication is critical to identify key prognostic indicators e.g. the role of tumour-infiltrating immune cells. These are identifiable in tissues by multiplex immunolabelling techniques. This is a powerful investigative tool providing objective quantitative data regarding the tumour immune context both number and location of immune subsets. The results can enable the selection of the exact immunotherapeutic regimen for any patient (e.g. application of single or combination of checkpoint blockade inhibitors) and can also predict therapy responses.  

The goal of precision medicine is not only to identify specific treatment for an individual’s disease, but hopefully will lead to future preventative care aiming to assure health over a lifetime.

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