TITLE:
About the Feasibility of Personalized Medicine in a Low Income Country?
AUTHORS:
Mona Mlika, Emna Braham, Soumaya Laabidi, Hamouda Boussen, Faouzi El Mezni
KEYWORDS:
Personalized Medicine, Target Therapies, Low Income Country
JOURNAL NAME:
Open Journal of Social Sciences,
Vol.3 No.5,
May
8,
2015
ABSTRACT: Personalized medicine is the result of the research made on the field of molecular biology. Lung cancer was mainly concerned with the establishment of many oncogenic drivers. Nowadays, the pathologist is facing a dilemma because of the multiplicity of therapeutic targets and molecular ones and the small size of specimen performed. In fact, 75% of lung cancer are diagnosed on biopsic samples. According to the recommendations of the 2013 International Group Study of Lung Cancer (IASLC), sequential analyses of Epidermal growth factor (EGFR) and anaplastic lym- phoma kinase (ALK) are necessary on adenocarcinomas, non small cell carcinomas not otherwise specified and non small cell carcinomas favor adenocarcinomas. Many interrogations are reported concerning the cost effectiveness of the diagnostic techniques and the targeted treatments. We wondered about the further feasibility of such a technique in a low income country by trying to explore the representativity of the samples. In our hospital, bronchoscopic biopsies are diagnostic in 75% of the cases. We receive a mean of 4 samples. 68% of the samples are tumoral. Immuno-histochemistry is performed in 68% of the cases with a mean of 2 antibodies used and 8% of the biopsies are non interpretable because of the small size of specimen. Concerning transthoracic biopsies, 20% are non contributive because of necrosis or the small size. We receive a mean of 1 sample with a mean size of 6 millimeters. Immunohistochemistry is performed in 71% of the cases with the mean of 2 antibodies. In addition to the scientific, pharmacoeconomic and ethic problems induced by targeted therapies in low income countries, each institution should optimize the use of the specimen received and the technical conditions in order to be ready to answer to the IASLC recommendation.