Sample Solution
During my recent trip to India, I was exposed to a culture that is drastically different from my daily life in the United States. One of the most striking differences were the building blocks upon which this culture is based. The primary focus seemed to be on social relationships and community engagement. There was an immense emphasis placed on familial connections, with people often referring to each other as brothers or sisters instead of simply acquaintances. This strong sense of belonging transcended generational barriers and extended beyond immediate family members into larger communities.
Additionally, religion played an exceedingly important role in Indian culture. Religion provided comfort and solace for many individuals while simultaneously offering practical guidance regarding everyday life decisions. People routinely gathered together at temples, mosques or churches in order to share their beliefs with like-minded individuals and build meaningful connections throughout society.
These values were exhibited through daily practices such as traditional meals eaten together or weekly religious ceremonies held by families within their homes; both activities featured prominently during my stay in India and provided me with insight into how much importance was placed on social bonds within this particular cultural context.
I recently encountered a culture while traveling to the Middle East. This was my first time visiting this part of the world, and I was taken aback by how different it was from what I knew back home.
The most striking thing about this culture is its traditionalism. In almost every aspect of life, tradition reigns supreme here—from the way people dress and speak, to how they interact with others and solve problems. Men often wear kanduras (ankle-length white robes) and women wear abayas (long black robes). Social hierarchies are determined by age, gender, ethnicity and religion; older relatives are respected for their wisdom and authority over younger generations. Similarly, men usually take priority in situations such as business dealings or family disputes.
The basic aim of the personalized medicine is applying right therapy to the right population of people by defining disease at the moecular level. So, identifying differences among the individuals support the new treatment methods and pharmaceutical companies to develop new cancer drugs. Patients who have similar clinical outcome and histological tumor type can give different response to the same drug(17). Prediction of who will be a nonresponders reduces the harmfull effect of drug on nonresponders like a potential toxic effect of drug and cost effect. Also when drug companies develop new drug, they focus on the patient population that benefit from drug to increase positive responds(17).
U.S. Food and Drug Administration bringed development about targeted therapy. For example, to treat chronic myeloid leukemia and gastrointestinal stromal tumor(18) ,imatinib mesylate is used and to treat breast cancer(19), trastuzumab (Herceptin) is used. Molecular characteristics of these cancer types that are abnormal protein tyrosine kinase activity in chronic myeloid leukemia and gastrointestinal stromal tumor and HER-2 receptor in breastcancer is used as a predictive biomarker. By using these markers only individuals which have these molecular alteration is selected and it means they are favorable for the treatment. Using this way some cancer types’ survival rate is shifted from 0 to 70%(17).
This application is used in non-small cell lung cancer treatment with using of mutations screeing. In this cancer type mutation occurs in kinase domain of EGFR. Gefitinib (Iressa) and erlotinib are tyrosine kinase inhibitors drug are used to treat and patients give a higher response to the treatment(20). Also if patient that is never smoked Asian females have adenocarcinomas, these drugs efficient on them(21). On the other hand, if the mutatuions occur at downstream effector KRAS, patient is resistant to to erlotinib(22). Also mutations that is at KRAS have a resistance to cetuximab (Erbitux) and panitumumab (Vectibix) drugs in colon cancer patients. If the KRAS is wild type, these these drugs is effective on the patients(23). These responses that are specific and different are based on molecular profile. Some molecular test are done before the using of cetuximab or panitumumab to a colon cancer patient. Lung and colon cancer is concerned with targeted therapy that is guide to patient about treatment by understanding the structure of cancer(24).
Pharmacogenomics and treatment safety
Genes that have genetical variation encode enzymes which metobolize drug, drug transporters, or drug targets. Variation in genes that can predict dose and safety of treatment for different types of cancer patient can have harmful influence on these patients’ treatment(25). For instance, polymorphism where in cytochrome P450 enzymes could cause to metabolite to drug slowly or very fast. So patient give an overdose symptoms or no response to drug by changing the pharmacokinetics of drug metabolism, also it may cause an adverse drug reaction(26). Thereby , forecasting optimal dose of drug , inducing the harmful side effects can be provided by using polymorphism(27). In familial breast cancer, patients shows low survival rate to treatment with tamoxifen that is chemotherapeutic drug because of genetic variation in CYP2D6 that is seen as a poor metabolizer (28). There are some studies abour genetic testing on drug label including test for CYP450 polymorphisms.
Prognosis
Insteaf of using clinicopathologic parameters as a biomarker in biochemical testing for prognosis and selection of therapatic way for cancer patient , Genotyping or gene expression profiling by microarray and protein analysis by mass spectrometry is used for prognostic biomarkers with the understanding of the molecular mechanism of cancer subtypes(29).
Biomarkers can be used alone or with combination of other parameters for classify subgroups according to their risk rate and for leading to therapy decision. For example, tissue microarray analysis with combining molecular and clinical biomarker is more efficient than the clasical cl
Hi, Welcome to Compliant Papers.