the large variety of disease manifestations, it is up to the personalized approach to
try and find the best solution for the patient.^26
The advances in diagnostics and the development of new,‘smart’drugs has
heralded a new era of the everlasting battle against the malignant diseases,
converting some of them from deadly to chronic morbidities. The pathogenetic
and interindividual diversity regarding the origin, course of the disease, and the
response to therapy (ranging from dramatic improvement to rapid-developing
resistance) makes the disease unpredictable and elusive in terms of finding the
absolute cure.^27 Personalized medicine becomes a necessity as the revelation of a
crucial pathogenetic pathway(s) can also mean a cure. In modern scientific
malignancy-related researches, science of the genome (genomics) is giving way
to a much more complex science of proteins (proteomics), glycoproteins
(glycoproteomics), and overall metabolism (metabolome). With the interaction of
millions and billions of molecules and interindividual diversity, it is clear that
personalized medicine will have to be incorporated into future clinical aspects of
malignant disease treatment with a special emphasis on preventive strategies and
determination of biomarkers of early disease.^28
4 Conclusion
Personalized medicine systematically uses all available information about a patient,
including his/her molecular make-up, in order to optimize preventive, diagnostic,
and/or therapeutic measures.^29 Although certain/specific personalized medicine
methods are used in everyday practice, educational initiatives, the development
of new curricula, and the introduction of new genetic knowledge into clinical
medicine are needed for efficient future development of this field. In this respect,
translational medicine plays an important role since its idea of vertical integration
of molecular and cellular interactions with clinical outcome reflects the integrative
approach to the patient as a unique being.
Cost-effectiveness, clinical applicability, development of new disease bio-
markers, new therapeutic targets, and new diagnostic possibilities are goals that
personalized medicine must meet in order to achieve better treatment outcomes.
There are still many obstacles, economic constraints, and ethical dilemmas that
must be overcome and resolved. Because of its comprehensiveness, personalized
medicine will inevitably extend and affect all areas, including gastroenterology and
other fields of clinical medicine.
(^26) Dignass et al. ( 2010 ).
(^27) Bouvier et al. ( 2010 ).
(^28) Schmalfuss and Kolominsky-Rabas ( 2013 ).
(^29) Guttmacher and Collins ( 2002 ); Zavod za javno zdravstvo “dr. Andrija Sˇtampar”,
Personalizirana medicina. Available at:http://www.stampar.hr/Default.aspx?art¼2229&sec¼ 16.
262 D. Sˇtimac and N. Franjic ́