Chang Ting-chang, the founding chairman of the Taiwan Society for Precision Medicine, said that genetic testing is the star of tomorrow for precision medicine.

Nowadays, medical treatment has gradually come to a bottleneck, because whether it is diagnosis or treatment, most of them are "patient standardization", which is "treating the disease" rather than "treating the person". So the same kind of disease, the same kind of treatment, some people are very successful, very effective, but there are patients who are completely ineffective, and Zhang Tingzhang is also worried about this.

Ting-chang Chang's bio

The founding chairman of the Taiwan Society for Precision Medicine, the head of the Women's Cancer Center at Chang Gung Hospital in Linkou, and the founding chairman of the Taiwan Cancer Registry Society, specializes in research and development of future cancer medicine. He specializes in the research and development of future cancer medicine. He expects to change the relationship between doctors and patients and improve the effectiveness of cancer treatment through precision medicine.

Zhang Ting-chang, for example, the current classification of cancer is divided into "organs" and tissue types, such as lung cancer and breast cancer; but in the process of treatment, some people's lung cancers are just not suitable for a certain kind of drug, and some people's breast cancers are suitable for other cancer drugs, but under the modern classification of medicine, these are not able to become the "standard of care".

"Nowadays, about half of the physicians don't understand what 'precision medicine' is, so there's no way to evaluate it systematically, and they can only rely on their own experience and the patient's feelings to adjust the treatment, but that's very inaccurate, and it's very difficult to cultivate the next generation of even better physicians," Chang said. said Ting-Chang Chang.

In order to find the "individual" differences in patients, and the differences in seemingly identical diseases, and to change the diagnosis and treatment of "equal treatment", "precision medicine" has been looking for a way to determine the "molecules", or even the "genes". With the rapid development of genetic testing technology, this has become possible.

"It sounds strange at first, but the differences in people are really so subtle. If you zoom in on a tumor, you'll see that everyone's lung cancer looks different, and now treatment has slowly moved from 'tissue' to 'molecules,' and in the case of lung cancer alone, we've found more than 30 molecular patterns.

So there is only one type of lung cancer, but in fact it can be divided into 30 different types, and the treatment is different for each of them, and the difference, in the past, would be said to be a "difference in constitution", but now it is understood to be a difference in genes.

"This is also a good direction for developing new drugs." Mr. Cheng also said, for example, the disease of a certain genotype, a specific drug will have a response, then as long as the characteristics of the drug to go to the test, more quickly can be developed for the "this genotype" of the drug, not as in the past, the development of drugs for "a certain kind of disease", the results are very poor.

But with the technology to detect genes, the next step is to find the solution to treating them. In order to achieve this goal, the best of the best from around the world are playing an important role in genetic testing, including computerized instruments, big data, the biotech industry, physicians, pharmaceutical companies, and more.

But at present, genetic testing is still dominated by manufacturers, in addition to cancer screening, such as drug screening, but also with major hospitals, trying to collect more data in cancer testing, so that humans can analyze the cancer more clearly, and the direction of treatment can be more accurate. The company's goal is to provide the best possible service to the public," said Mr. Kennedy, who is also a member of the Board of Directors.

And Zhang Ting-chang believes that in addition to these people, there is a more important part to focus on, and that is the patients themselves.

"We need to understand what precision medicine is, what genetic testing is, in order to understand what kind of changes are happening in medical treatments, and to be able to cooperate with the treatment. Because of this approach, because it is very specialized, more emphasis on the mutual trust between the doctor and the patient." Zhang Tingzhang said.

Because genetic testing into the medical, the first thing to face is "in the end is not effective" problem, Zhang Ting-chang said, "many people will think, I spend money is to extend life ah, is to be effective ah, but for the doctor, the treatment is absolutely not perfect, in case you can prolong the life, but the quality of life is very poor, so do you want to do?

So in Zhang Ting-chang's thinking, precision medicine is definitely something that needs to be developed, but it's also something that should be done at the same time to improve the general public's knowledge of their own bodies, "The physical condition has to be able to face it properly, and the development of treatments is only meaningful."

Another difficulty is that genetic testing requires a lot of statistics and analysis of big data, but now Taiwan has not yet established its own database, although there are many people who do genetic testing, but each manufacturer does not have a **** the same platform can be compared with each other and analyzed, and most of the time, they will be taken to foreign statistics to compare; the different races, different living environments, different judgmental criteria will be very different. The most important thing to remember is that you can't be sure that you're going to be able to get the best out of it.

"The main problem is that the regulations are not transparent enough, so people are at a loss, and the *** authorities have not come out to build a platform to share the information with each other, so that everyone can do their own thing. In the U.S. and the U.K., it's the *** that takes the initiative to summarize millions and millions of pieces of genetic information, but not in Taiwan," said Ting-Chang Chang. Zhang Ting-chang said.

In the face of such questions, the Ministry of Health and Welfare, Director of the Department of Medical Affairs Shi Chongliang said, in fact, *** has been in the planning, "It has been confirmed that at the end of this year, *** will be launched an integrated platform, and there is a counseling program to assist manufacturers to the hand of the information on the standardization of the integration of a data base, the future of this data base can also be provided to the biotechnology research and development.

It's just that genetic testing also involves the issue of privacy, so if you want to do scientific research and big data analysis, you have to get the consent of the subjects, so the question comes back to the "general public's knowledge of their own bodies, the degree of care".