Biology Reference
In-Depth Information
(
1
)
Current success rate is only ~50%
Responders (R)
x 100 = ~50 %
Total Number of Patients (T)
(
2
)
Since T = Responders (R) + Nonresponders (N),
-
R
x 100 = ~50 %
R + N
(
3
)
The success rate can be improved in two ways:
i) By increasing R Produce better drugs (
Therapy
)
ii) By decreasing N Develop diagnostics to detect & exclude non-responders
from Clinical Trials (
Diagnostics
&
Prognostics
)
'Theragnostics'
Fig. 19.1
How to improve the success rate of drug therapy, and the need for developing
theragnostics
(also called
theranostics
) as a combined field of
therapy
,
diagnostics
, and
prognostics
two scales - the “chronic” timescale of weeks to months and the “acute” timescale
of minutes to hours, and the
y
-axis registers some quantitative index of the morbid-
ity under consideration, for example, breast tumor. Two types of raw data can be
employed for theragnostics, both providing two independent information and
hence, when used together,
increasing the confidence level of theragnostic
determinations.
The nine panels of t-ribons shown in the rows labeled Time Series A, B, and C
are hypothetical levels of the RNA molecules belonging to one or more specific
metabolic pathways (such as glycolysis, oxidative phosphorylation, and fatty acid
catabolism). At “chronic” times of T1, T2, and T3 (which can range from weeks to
months), cell samples were obtained and their RNA levels were measured at acute
times (ranging from minutes to hours after applying a common perturbation such as
glucose-galactose shift). These nine t-ribons divide into three groups - (1) Group I
consisting of the t-ribons located at boxes A-T1, A-T2, and A-T3 that represent the
biomarkers of normal cells, (2) Group II consisting of the t-ribons at B-T1, B-T3,
and C-T1, and (3) Group III consisting of the t-ribons at B-T2, C-T2, and C-T3.
Group I t-ribons, Group II t-ribons represent the biomarkers of disease-susceptible
cells, and Group III t-ribons are the biomarkers of the diseased cells. From the
pattern of distribution of these three groups of t-ribons, we can conclude that Type
A cells are normal, Type B cells are disease-susceptible but favorably respond to
drug therapy, and Type C cells are disease-susceptible and resistant to drug therapy.
It is predicted that the same theragnostic results can be obtained from the same
set of cell types if s-ribons, rather than t-ribons, are measured with microarrays
as illustrated in the nine s-ribons shown in the lower three rows of Table
19.1
. The
s-ribons shown in these panels are the result of microarray measurement made on
