What are the innovations of gene technology in clinical practice?

Precise medical care in the end what is the point? What are the innovations of gene technology in clinical practice? Below, I will by application of gene technology in the field of lung cancer we see only a small part of A.

Lung cancer is the highest incidence of cancer in China, in China, lung cancer each year will take about 600 thousand people's lives, is expected to 2025, China's lung cancer patients will reach 1 million cases, this is a very scary data. How to prevent lung cancer by gene technology?

Assuming that there is a A, 45 years old, perennial smoking, or long-term exposure to PM2.5 serious excessive environment, then Mr. A belongs to the high incidence of lung cancer, should be regularly to accept the early screening of lung cancer. Currently clinically for lung cancer early screening, mainly using low dose spiral CT and blood tumor markers, but missed the screening rate is very high, the timing of treatment of patients with severe delays. In fact, at present, more than 70% of lung cancer patients in our country at the time of diagnosis, it is already advanced lung cancer. Whether gene technology can solve this problem?

The answer is yes. At present, this kind of technology is developing at a high speed, in the market cultivation stage, it is the "MIT Technology Review Magazine" as one of the ten breakthrough technology in 2015, one of the "liquid biopsy" technology. On 11 January 2016, CFDA approved the application of independent research and development of domestic companies geno biological to lung cancer CTC detection products, the product is the traditional method for more than 90% of the early lung cancer detection rate was reduced to 20%, that is, at present clinical have more accurate method to do screening for early lung cancer, but the price is relatively expensive, public information 3000-3600 yuan per case.

Next, we still take Mr. A as an example, to give you a brief introduction to the application of gene technology in the field of medication guidance (along with the diagnosis). If Mr. a there is no regular screening for lung cancer, but unfortunately diagnosed lung cancer late, often surgical treatment at this stage is not suitable, usually the doctor will take a combination of radiotherapy and chemotherapy for the treatment of a Mr.. How to choose chemotherapy drugs?

Study found that target to the drug is better than the conventional chemotherapy, but only carry specific molecular genetic markers of population to benefit from, such as lung cancer patients in most of the EGFR (epidermal growth factor receptor) gene mutation positive patients, the target to the drug's effect is good. The clinical doctors usually requires the use of lung puncture. First, collect tissue of patients with lung tumor, pathology and genetic detection of the, and accept such intrusion detection to the patient is greater risk, such as the occurrence of pneumothorax and other symptoms. June 1, 2016, FDA approved Roche a for non small cell lung cancer patients with detection of EGFR gene mutations in the liquid biopsy products, do not need to puncture, only need a blood test can be. Once this product is widely used in clinical practice, it is very suitable for patients with lung cancer who are not suitable for sampling.

So, gene technology in the treatment of lung cancer can also play a significant role in it? The answer is yes. Back to Mr. A, Mr. A's lung cancer was diagnosed late, the effect was not obvious after the targeted therapy, so he decided to try the latest immunotherapy technology CART therapy. At present, clinical therapeutic effect of cart therapy of B lymphocytic leukemia is very significant, five year survival rate can reach more than 90%, efficacy in solid tumors is not enough, but there have been many scholars engaged in research work of cart in treatment of lung cancer, perhaps in the future, like Mr. a this kind of lung cancer can by cart technology to be cured, and gene technology will greatly promote cart therapy the clinical development process. There is a need to introduce a new technique called gene editing technology.

In short, gene editing technology is a means of genetic engineering, so that people can easily edit the target gene. For example, in order to prevent the body's rejection reaction, at present in the treatment of CAR-T is the best way to collect the patient's own immune cells, in vitro transformation and then back to the patient. This completely personalized treatment led to the cost of CART therapy is difficult to reduce, the cost of treatment up to $400 thousand. How to reduce costs? A French cart treatment cellectis is trying the gene editing means, "closed" lead to rejection of gene excretion from the body. This cart cell to mass production, which will greatly reduce the cost of treatment.

Finally, the significance of gene diagnosis in the patient's condition monitoring and prognosis. After treatment, Mr. A's condition was under control, home to rest. Next, Mr. A needs to go to the hospital for a comprehensive physical examination, on the one hand, to observe the efficacy of early, on the other hand, to detect whether there is a proliferation of cancer. At present, mainly through the PET/CT, serum tumor marker detection for monitoring, not sensitive and accurate. The latest progress is through liquid biopsy technique for the detection of tumors in the blood of patients with circulating tumor cells and ctDNA to ensure higher, a more timely detection rate, but also to gene mutation detection of tumor cells and accurate response to tumor cells produce the problem of resistance.