Ravi Salgia - Oncology in the Precision Medicine Era: Value-Based Medicine

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Just a few years ago, medicine, as we knew it, revolved around standards of care, the best practices of treatment or prevention for the patient. In other words, it was a one-size-fits-all approach for a given indication. Over the past decade, however, there has been a revolution, and a number of therapies, protocols, and diagnostic products that tend to personalize medicine signaling a new era have entered the clinic or come on the horizon. Thus, targeted therapies, tailored for patients with specific genetic alterations in actionable targets, such as oncogenes, have replaced conventional therapies. Such therapies have admittedly fared better with a relatively quick response rate but can be fairly ineffective or, even worse, have undesirable adverse effects if administered to a patient lacking the qualifying traits despite having the same disease/indication. Furthermore, the emergence of drug resistance in patients that respond well initially still remains a concern.

Value-Based Medicine: Oncology in the Personalized/Precision Medicine Eracovers the subject in depth across various types of cancers and addresses many of these concerns. It is organized and written in a format that is easy to follow for both clinicians and non-clinician scientists interested in personalized medicine. The chapters in the book range from defining the clinical problem and summary of recent findings, tumor biology and heterogeneity, genomics, examples of simple/complex cases, the biological pathways, future clinical trials, and financial considerations. Each chapter that is devoted to a cancer type is written by experts who are actively involved in translational research. With no comparable works to compete, this thoughtful treatise should serve as a useful resource for medical oncologists and healthcare providers looking toward a future where all stages of patient care, from prevention to diagnosis to treatment to follow-up, are truly personalized.

It is hoped that the book will serve as a reference for those interested in tailoring medicine to the needs of the individual patient and keep themselves abreast of the latest developments in the field, especially with regard to current evidence, indications, and clinical trials for the treatment of cancer with targeted therapies, immunotherapies, and epigenetic modulators. The book is primarily meant for medical professionals and trainees including students, residents, and fellows interested in treating lung cancer. However, we envisage that the book may also be well suited for scientists as well as advanced graduate students working on cancer both in academia and industry.

I would like to thank my wife, Deborah, and children, Sabrina, Meghan, and Nicholas, for who they are and how supportive they have been and the patients and their families for the inspiration. This endeavor would not have been possible without the cooperation and enthusiasm of my esteemed colleagues who graciously agreed to contribute their respective chapters. I would like to thank my parents, Dr. Karanmal Salgia and Mrs. Kalavati Salgia, for always being supportive. I would especially like to thank Dr. Prakash Kulkarni for his endless energy, help, and friendship. Finally, I am pleased to acknowledge Ms. Margaret Burns, Developmental Editor, from Springer for her unstinted support and dedication. This book is dedicated to the memory of my father who was always very enthusiastic about medicine and caring for others.