Introduction
The rate of incidence and mortality of patients suffering from cancer has increased by humongous numbers. It is reported on account of increased population, unhealthy lifestyle, exposure to the associated risk factors, and disparities in the quality of cancer prevention, diagnosis, and treatment. Recent research from GLOBOCAN (Global Cancer Observatory) has stated that 19.3 million new cancer cases and more than 10 million deaths have been reported. Talking about urological cancers and the urinary system, prostate cancer represented the most numbers urological cancer and ranked 3rd in the list of most prevalent cancers; bladder cancer is the 2nd most pervasive urological cancer, ranking in the 11th position among the worldwide most common type of cancers, and kidney cancer, renal cell carcinoma represents 90 % of kidney cancers. These are commonly occurring types of urological cancers.
An immense amount of progress has been made in the understanding of the etiology and identifications and improvement of treatment modalities of cancer. Nowadays, a comprehensive approach to treating cancer is available to cure cancer. Treatments like surgery, chemotherapy, radiation, hormonal therapy, targeted cell therapy, and immunotherapy are emerging to provide the best results. Understanding the genetic and non-genetic characteristics, proteomics, metabolomics of the disorder, and personalized medicine can help to get the most appropriate treatment.
What Is Precision or Personalized Medicine?
Precision medicine is a treatment modality for treating cancer that tends to provide personalized treatment to each affected patient with cancer. A targeted treatment approach that goes beyond just treating the disease, an indication of precision medicine also studies multiple aspects of a patient’s health, such as their genetic formation, environmental factors, and lifestyle choices and patterns. Personalized medicine provides the opportunity to decrease the associated risk factors, side effects, patient compliance, cost-effectiveness, and targeted therapy in medical interventions. However, there are some challenges related to personalized medicine.
What Is the Role of Genetics in Precision Medicine?
Precision medicine is indicated after a complete study of the patient’s major factors like deoxyribonucleic acid (DNA), gene sequences, and unique genetic history. Cancer can be a result of genetic abnormalities that lead to aggressive cell growth, multiply, and formation of tumors. The study of patient genetics provides the safest and most effective personalized treatment plans for each individual patient.
What Is Pharmacometabolomics?
Pharmacometabolomics, defined as a branch of metabolomics, is an attractive tool to predict drug response in an individual based on its own metabolic signature, which can be collected before, during, and after drug exposure. Identify the tumor by molecular profiling using genomics, proteomics, and metabolomics testing to understand and help the health care provider in treatment planning for the patient. The administration of pharmacy metabolomic approaches to detect the metabolic responses to hormone therapy, targeted therapy, immunotherapy, and chemotherapy for the most prevalent urological cancers.
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Pharmacogenomics - It is defined as the study of a patient’s genetic profile to forecast the effectiveness of the precise medicine.
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Pharmacometabolomics - It is defined as an enhanced understanding of mechanisms for drug or xenobiotic effect and an increased ability to predict individual variation in drug response phenotypes, based on using both baseline metabolic profiles prior to treatment and also results of drug treatment over time.
What Is the Workflow of Pharmacometabolomics?
The pharmacometabolomics study combines sample handling, metabolite extraction, detection, and interpretation of the result of the treatment. The workflow follows a series of actions after sample collection. The next step is data acquisition which involves nuclear magnetic resonance spectroscopy, mass spectrometry-based techniques, and data pre-processing that contributes to noise filtering, peak directions, alignment, and normalization; statistical analysis involves multivariate and univariate analysis, biochemical interpretation involves pathway analysis and selection of possible biomarkers, and last clinical application is made check biomarker validation and development of models to predict therapeutic response.
What Are Pharmacometabolomics Studies in Urological Cancers?
Pharmacometabolomics is studied for urological cancer to identify the metabolic changes before and after sample collection. Pharmacometabolomics studies are done to determine the metabolic responses to hormone therapy, immunotherapy, targeted therapy, and chemotherapy in prostate cancer, bladder cancer, and renal cell carcinoma.
What Is Precision Medicine and Pharmacometabolomics Prostate Cancer?
Prostate cancer is one of the most common occurring urological cancers. The need for personalized medicine in the treatment of prostate cancer due to its heterogeneity and the prognosis of a patient does not entirely depend on TNM staging and prostate-specific antigen. Pharmacometabolomics approaches involve the pattern of metabolites with the potential to be candidate biomarkers of therapeutic response and related metabolic pathways, as castration resistance is a common problem in prostate cancer. Pharmacometabolomics help to identify the specific biomarkers associated with resistance development to enhance the effectiveness of the treatment.
What Is Precision Medicine and Pharmacometabolomics Bladder Cancer?
Patients suffering from bladder cancer may show some resistance to Cisplatin. Cisplatin is a commonly used drug in chemotherapy for the treatment of bladder cancer. Initially, the patient may have some susceptibility to Cisplatin, but as the treatment goes on and resistance to the drug can be observed. Many studies have been conducted regarding pharmacometabolomics, and it is reported that the combination of Gemcitabine and Cisplatin should be recommended in the treatment of Bladder cancer.
What Is Precision Medicine and Pharmacometabolomics Renal Cell Carcinoma?
In patients with renal cell carcinoma, an indication of first-line therapy includes inhibitors of tyrosine kinases such as Sunitinib, Pazopanib, Tivozanib, and Cabozantinib. With the help of pharmacometabolomics, the identification of biomarkers is made, and the impact of immunotherapy is enhanced.
Conclusion
Precision or personalized medicine for the treatment of cancer enhances the treatment modality. With the help of genomic profiling of the tumors, the treatment decisions may vary and provide a different strategy to the health care provider to treat cancer and its type.
However, these pharmacometabolomics methods improve cancer therapies, opting for the best treatment modality according to the metastatic stages in urological cancers.
Further studies are required to validate and determine the impact of the different treatments of urological cancer. In future pharmacometabolomics studies, it is essential to consider the standardization of protocols for sample handling and storage, analytical conditions, and data interpretation.
