4 The report also looked at the need for changing

roles of key stakeholders in successful transformation of services in health care, required to successfully implement personalized medicine practices. These analyses featured some of the implementation issues Wortmannin in vitro associated with personalized medical care and some of the solutions to overcome them. Definitions and context of personalized medicine The use of the term “personalized medicine” in the literature predates the advances in clinical genomics that have advanced the biological understanding of differences between individuals. Applications of this terminology were often related Inhibitors,research,lifescience,medical to customized behavioral approaches to management of health conditions. Prior to the 1990s, the use of the term “personalized medicine” was used to imply that there were Inhibitors,research,lifescience,medical sociological, educational, and psychological bases for alternative approaches to patient management that led to more or less successful practices. In the late 1990s, somewhat simultaneously with the approaching completion of the Human Genome Project, more common usage of

the term reflected genetic understanding for differences in pharmacotherapy, ie, pharmacogenomics. This also coincided with the market entry of several molecularly targeted therapies in oncology that used genetically based determinants for the development and subsequent clinical application Inhibitors,research,lifescience,medical of novel therapeutic agents. Trastuzumab (Herceptin®), a monoclonal antibody that serves Inhibitors,research,lifescience,medical as a treatment for breast cancer, has often been heralded as the first molecular therapy ascribed to personalized medical applications through the use of an assay to detect overexpression of the Her2 protein, thereby identifying patients who are most likely to respond. Since then, there have been many interpretations and contexts applied to the term “personalized medicine.” For the purposes of this discussion, the definition used here will be based on one by Willard et al as “the delivery Inhibitors,research,lifescience,medical of health care in a manner that is informed by each person’s unique clinical information; genetic, genomic, and other molecular biological characteristics; and environmental influences. others The goals of personalized medicine

are to take advantage of a molecular understanding of disease, combined with other individual factors, to optimize preventive health care strategies while people are still well or at the earliest stages of disease.”5 Increasingly, consumer interactions with the health care system and engagement in proactive participation in agenda setting and decision making are being applied to new ends. The rise of advocacy organizations and their involvement in therapeutic development, application of social networking enterprises for patient connectivity (ie, PafientsLikeMe), greater involvement of public members in policy development, and growing public influences on coverage and reimbursement policies add new context to patient advocacy.