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Erschienen in: World Journal of Surgery 8/2011

01.08.2011

Overview of the Development of Personalized Genomic Medicine and Surgery

verfasst von: F. Charles Brunicardi, Richard A. Gibbs, David A. Wheeler, John Nemunaitis, William Fisher, John Goss, Changyi Chen

Erschienen in: World Journal of Surgery | Ausgabe 8/2011

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Abstract

Personalized genomic medicine and surgery (PGMS) represents a new approach to health care that customizes patients’ medical treatment according to their own genetic information. This new approach is the result of increased knowledge of the human genome and ways this information can be applied by physicians in the medical and surgical management of their patients. A patient’s genotype can yield important information concerning disease susceptibility and the effectiveness of medications, therefore guiding specific, targeted imaging and treatment therapies. This review summarizes major achievements of human genomic studies and applications of genomics in health care. Five years ago we developed a model for the development of PGMS in which genomic profile guides choice of therapy. In this article we discussed our progress, including an updating of the model, and a future vision of PGMS.
Literatur
1.
Zurück zum Zitat Obama B (2007) Genomics and personalized medicine act of 2007. U.S. Congress, Washington, DC Obama B (2007) Genomics and personalized medicine act of 2007. U.S. Congress, Washington, DC
4.
Zurück zum Zitat Ginsburg GS, Willard HF (2009) Genomic and personalized medicine: foundations and applications. Transl Res 154:277–287PubMedCrossRef Ginsburg GS, Willard HF (2009) Genomic and personalized medicine: foundations and applications. Transl Res 154:277–287PubMedCrossRef
5.
Zurück zum Zitat Spear BB, Heath-Chiozzi M, Huff J (2001) Clinical application of pharmacogenetics. Trends Mol Med 7:201–204PubMedCrossRef Spear BB, Heath-Chiozzi M, Huff J (2001) Clinical application of pharmacogenetics. Trends Mol Med 7:201–204PubMedCrossRef
6.
Zurück zum Zitat International Human Genome Sequencing Consortium (2001) Initial sequencing and analysis of the human genome. Nature 409:860–921CrossRef International Human Genome Sequencing Consortium (2001) Initial sequencing and analysis of the human genome. Nature 409:860–921CrossRef
7.
Zurück zum Zitat International Human Genome Sequencing Consortium (2004) Finishing the euchromatic sequence of the human genome. Nature 431:931–945CrossRef International Human Genome Sequencing Consortium (2004) Finishing the euchromatic sequence of the human genome. Nature 431:931–945CrossRef
9.
Zurück zum Zitat International HapMap Consortium (2003) The international HapMap project. Nature 426:789–796CrossRef International HapMap Consortium (2003) The international HapMap project. Nature 426:789–796CrossRef
10.
Zurück zum Zitat International HapMap Consortium (2007) A second generation human haplotype map of over 3.1 million SNPs. Nature 449:851–861CrossRef International HapMap Consortium (2007) A second generation human haplotype map of over 3.1 million SNPs. Nature 449:851–861CrossRef
11.
Zurück zum Zitat The International HapMap 3 Consortium (2010) Integrating common and rare genetic variation in diverse human populations. Nature 467:52–58CrossRef The International HapMap 3 Consortium (2010) Integrating common and rare genetic variation in diverse human populations. Nature 467:52–58CrossRef
12.
Zurück zum Zitat Artiga MJ, Bullido MJ, Frank A (1998) Risk for Alzheimer’s disease correlates with transcriptional activity of the APOE gene. Hum Mol Genet 7:1887–1892PubMedCrossRef Artiga MJ, Bullido MJ, Frank A (1998) Risk for Alzheimer’s disease correlates with transcriptional activity of the APOE gene. Hum Mol Genet 7:1887–1892PubMedCrossRef
13.
Zurück zum Zitat Holmes C (2002) Genotype and phenotype in Alzheimer’s disease. Br J Psychiatry 180:131–134PubMedCrossRef Holmes C (2002) Genotype and phenotype in Alzheimer’s disease. Br J Psychiatry 180:131–134PubMedCrossRef
14.
Zurück zum Zitat Belbin O, Dunn JL, Ling Y et al (2007) Regulatory region single nucleotide polymorphisms of the apolipoprotein E gene and the rate of cognitive decline in Alzheimer’s disease. Hum Mol Genet 16:2199–2208PubMedCrossRef Belbin O, Dunn JL, Ling Y et al (2007) Regulatory region single nucleotide polymorphisms of the apolipoprotein E gene and the rate of cognitive decline in Alzheimer’s disease. Hum Mol Genet 16:2199–2208PubMedCrossRef
15.
Zurück zum Zitat van Vliet P, Westendorp RG, Eikelenboom P et al (2009) Parental history of Alzheimer disease associated with lower plasma apolipoprotein E levels. Neurology 73:681–687PubMedCrossRef van Vliet P, Westendorp RG, Eikelenboom P et al (2009) Parental history of Alzheimer disease associated with lower plasma apolipoprotein E levels. Neurology 73:681–687PubMedCrossRef
17.
Zurück zum Zitat Kidd JM, Cooper GM, Donahue WF et al (2008) Mapping and sequencing of structural variation from eight human genomes. Nature 453:56–64PubMedCrossRef Kidd JM, Cooper GM, Donahue WF et al (2008) Mapping and sequencing of structural variation from eight human genomes. Nature 453:56–64PubMedCrossRef
18.
Zurück zum Zitat Sebat J, Lakshmi B, Troge J et al (2004) Large-scale copy number polymorphism in the human genome. Science 305:525–528PubMedCrossRef Sebat J, Lakshmi B, Troge J et al (2004) Large-scale copy number polymorphism in the human genome. Science 305:525–528PubMedCrossRef
19.
Zurück zum Zitat Iafratel AJ, Feuk L, Rivera MN et al (2004) Detection of large-scale variation in the human genome. Nat Genet 36:949–951CrossRef Iafratel AJ, Feuk L, Rivera MN et al (2004) Detection of large-scale variation in the human genome. Nat Genet 36:949–951CrossRef
20.
Zurück zum Zitat Lee JA, Carvalho CM, Lupski JR (2007) A DNA replication mechanism for generating nonrecurrent rearrangements associated with genomic disorders. Cell 131:1235–1247PubMedCrossRef Lee JA, Carvalho CM, Lupski JR (2007) A DNA replication mechanism for generating nonrecurrent rearrangements associated with genomic disorders. Cell 131:1235–1247PubMedCrossRef
21.
Zurück zum Zitat Redon R, Ishikawa S, Fitch KR et al (2006) Global variation in copy number in the human genome. Nature 444:444–454PubMedCrossRef Redon R, Ishikawa S, Fitch KR et al (2006) Global variation in copy number in the human genome. Nature 444:444–454PubMedCrossRef
22.
Zurück zum Zitat Freeman JL, Perry GH, Feuk L et al (2006) Copy number variation: new insights into genome diversity. Genome Res 16:949–961PubMedCrossRef Freeman JL, Perry GH, Feuk L et al (2006) Copy number variation: new insights into genome diversity. Genome Res 16:949–961PubMedCrossRef
23.
Zurück zum Zitat Zhang F, Gu W, Hurles ME et al (2009) Copy number variation in human health, disease, and evolution. Annu Rev Genomics Hum Genet 10:451–481PubMedCrossRef Zhang F, Gu W, Hurles ME et al (2009) Copy number variation in human health, disease, and evolution. Annu Rev Genomics Hum Genet 10:451–481PubMedCrossRef
24.
Zurück zum Zitat Gonzalez E, Kulkarni H, Bolivar H (2005) The influence of CCL3L1 gene-containing segmental duplications on HIV-1/AIDS susceptibility. Science 307:1434–1440PubMedCrossRef Gonzalez E, Kulkarni H, Bolivar H (2005) The influence of CCL3L1 gene-containing segmental duplications on HIV-1/AIDS susceptibility. Science 307:1434–1440PubMedCrossRef
25.
Zurück zum Zitat Aitman TJ, Dong R, Vyse TJ et al (2006) Copy number polymorphism in Fcgr3 predisposes to glomerulonephritis in rats and humans. Nature 439:851–855PubMedCrossRef Aitman TJ, Dong R, Vyse TJ et al (2006) Copy number polymorphism in Fcgr3 predisposes to glomerulonephritis in rats and humans. Nature 439:851–855PubMedCrossRef
26.
Zurück zum Zitat Wheeler DA, Srinivasan M, Egholm M et al (2008) The complete genome of an individual by massively parallel DNA sequencing. Nature 452:872–876PubMedCrossRef Wheeler DA, Srinivasan M, Egholm M et al (2008) The complete genome of an individual by massively parallel DNA sequencing. Nature 452:872–876PubMedCrossRef
27.
Zurück zum Zitat Levy S, Sutton G, Ng PC et al (2007) The diploid genome sequence of an individual human. PLoS Biol 5:e254PubMedCrossRef Levy S, Sutton G, Ng PC et al (2007) The diploid genome sequence of an individual human. PLoS Biol 5:e254PubMedCrossRef
28.
Zurück zum Zitat Fujimoto A, Nakagawa H, Hosono N et al (2010) Whole-genome sequencing and comprehensive variant analysis of a Japanese individual using massively parallel sequencing. Nat Genet 42:931–936PubMedCrossRef Fujimoto A, Nakagawa H, Hosono N et al (2010) Whole-genome sequencing and comprehensive variant analysis of a Japanese individual using massively parallel sequencing. Nat Genet 42:931–936PubMedCrossRef
29.
Zurück zum Zitat Sobreira NLM, Cirulli ET, Avramopoulos D et al (2010) Whole-genome sequencing of a single proband together with linkage analysis identifies a mendelian disease gene. PLoS Genet 6:e1000991PubMedCrossRef Sobreira NLM, Cirulli ET, Avramopoulos D et al (2010) Whole-genome sequencing of a single proband together with linkage analysis identifies a mendelian disease gene. PLoS Genet 6:e1000991PubMedCrossRef
30.
Zurück zum Zitat Lupski JR, Reid JG, Gonzaga-Jauregui C et al (2010) Whole-genome sequencing in a patient with Charcot-Marie-Tooth neuropathy. N Engl J Med 362:1181–1191PubMedCrossRef Lupski JR, Reid JG, Gonzaga-Jauregui C et al (2010) Whole-genome sequencing in a patient with Charcot-Marie-Tooth neuropathy. N Engl J Med 362:1181–1191PubMedCrossRef
32.
Zurück zum Zitat Farmer H, McCabe N, Lord CJ et al (2005) Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy. Nature 434:917–921PubMedCrossRef Farmer H, McCabe N, Lord CJ et al (2005) Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy. Nature 434:917–921PubMedCrossRef
33.
Zurück zum Zitat Venkitaraman AR (2002) Cancer susceptibility and the functions of BRCA1 and BRCA2. Cell 108:171–182PubMedCrossRef Venkitaraman AR (2002) Cancer susceptibility and the functions of BRCA1 and BRCA2. Cell 108:171–182PubMedCrossRef
34.
Zurück zum Zitat Roukos DH, Briasoulis E (2007) Individualized preventive and therapeutic management of hereditary breast ovarian cancer. Nat Clin Pract Oncol 4:578–590PubMedCrossRef Roukos DH, Briasoulis E (2007) Individualized preventive and therapeutic management of hereditary breast ovarian cancer. Nat Clin Pract Oncol 4:578–590PubMedCrossRef
36.
Zurück zum Zitat Struewing JP, Hartge P, Wacholder S et al (1997) The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. N Engl J Med 336:1401–1408PubMedCrossRef Struewing JP, Hartge P, Wacholder S et al (1997) The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. N Engl J Med 336:1401–1408PubMedCrossRef
37.
Zurück zum Zitat Ries LAG, Harkins D, Krapcho M et al (2006) SEER cancer statistics review, 1975–2003. National Cancer Institute, Bethesda Ries LAG, Harkins D, Krapcho M et al (2006) SEER cancer statistics review, 1975–2003. National Cancer Institute, Bethesda
38.
Zurück zum Zitat Narod SA, Offit K (2005) Prevention and management of hereditary breast cancer. J Clin Oncol 23:1656–1663PubMedCrossRef Narod SA, Offit K (2005) Prevention and management of hereditary breast cancer. J Clin Oncol 23:1656–1663PubMedCrossRef
39.
Zurück zum Zitat Wiesner G, Slavin T, Barnholtz-Sloan J (2009) Colorectal cancer. In: Willard H, Ginsburg GS (eds) Genomic it personalized medicine. Elsevier, Durham, pp 879–897CrossRef Wiesner G, Slavin T, Barnholtz-Sloan J (2009) Colorectal cancer. In: Willard H, Ginsburg GS (eds) Genomic it personalized medicine. Elsevier, Durham, pp 879–897CrossRef
40.
Zurück zum Zitat Manolio T, Brooks L, Collins FS (2008) A HapMap harvest of insights into the genetics of common disease. J Clin Invest 118:1590–1605PubMedCrossRef Manolio T, Brooks L, Collins FS (2008) A HapMap harvest of insights into the genetics of common disease. J Clin Invest 118:1590–1605PubMedCrossRef
42.
Zurück zum Zitat Schwarz UI (2003) Clinical relevance of genetic polymorphisms in the human CYP2C9 gene. Eur J Clin Invest 33:23–30PubMedCrossRef Schwarz UI (2003) Clinical relevance of genetic polymorphisms in the human CYP2C9 gene. Eur J Clin Invest 33:23–30PubMedCrossRef
43.
Zurück zum Zitat Rost S, Fregin A, Ivaskevicius V et al (2004) Mutations in VKORC1 cause warfarin resistance and multiple coagulation factor deficiency type 2. Nature 427:537–541PubMedCrossRef Rost S, Fregin A, Ivaskevicius V et al (2004) Mutations in VKORC1 cause warfarin resistance and multiple coagulation factor deficiency type 2. Nature 427:537–541PubMedCrossRef
44.
Zurück zum Zitat Oldenburg J, Watzka M, Rost S et al (2007) VKORC1: molecular target of coumarins. J Thromb Haemost 5(1):1–6PubMedCrossRef Oldenburg J, Watzka M, Rost S et al (2007) VKORC1: molecular target of coumarins. J Thromb Haemost 5(1):1–6PubMedCrossRef
46.
Zurück zum Zitat Higgins MJ, Stearns V (2011) Pharmacogenetics of endocrine therapy for breast cancer. Annu Rev Med 62:281–293PubMedCrossRef Higgins MJ, Stearns V (2011) Pharmacogenetics of endocrine therapy for breast cancer. Annu Rev Med 62:281–293PubMedCrossRef
47.
Zurück zum Zitat Dezentjé VO, Guchelaar HJ, Nortier JW et al (2009) Clinical implications of CYP2D6 genotyping in tamoxifen treatment for breast cancer. Clin Cancer Res 15:15–21PubMedCrossRef Dezentjé VO, Guchelaar HJ, Nortier JW et al (2009) Clinical implications of CYP2D6 genotyping in tamoxifen treatment for breast cancer. Clin Cancer Res 15:15–21PubMedCrossRef
50.
Zurück zum Zitat Dowsett M, Dunbier AK (2008) Emerging biomarkers and new understanding of traditional markers in personalized therapy for breast cancer. Clin Cancer Res 14:8019–8026PubMedCrossRef Dowsett M, Dunbier AK (2008) Emerging biomarkers and new understanding of traditional markers in personalized therapy for breast cancer. Clin Cancer Res 14:8019–8026PubMedCrossRef
51.
Zurück zum Zitat Romond EH, Perez EA, Bryant J et al (2005) Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 353:1673–1684PubMedCrossRef Romond EH, Perez EA, Bryant J et al (2005) Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 353:1673–1684PubMedCrossRef
52.
Zurück zum Zitat Piccart-Gebhart MJ, Procter M, Leyland-Jones B et al (2005) Herceptin adjuvant (HERA) trial study team. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Eng J Med 353:1659–1672CrossRef Piccart-Gebhart MJ, Procter M, Leyland-Jones B et al (2005) Herceptin adjuvant (HERA) trial study team. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Eng J Med 353:1659–1672CrossRef
53.
Zurück zum Zitat Ross JS, Slodkowska EA, Symmans WF et al (2009) The HER-2 receptor and breast cancer: ten years of targeted anti-HER-2 therapy and personalized medicine. Oncologist 14:320–368PubMedCrossRef Ross JS, Slodkowska EA, Symmans WF et al (2009) The HER-2 receptor and breast cancer: ten years of targeted anti-HER-2 therapy and personalized medicine. Oncologist 14:320–368PubMedCrossRef
54.
Zurück zum Zitat Bang Y, Chung H, Xu J et al (2009) Pathological features of advanced gastric cancer (GC): relationship to human epidermal growth factor receptor 2 (HER2) positivity in the global screening programme of the ToGA trial. J Clin Oncol 27 abstract 4556 Bang Y, Chung H, Xu J et al (2009) Pathological features of advanced gastric cancer (GC): relationship to human epidermal growth factor receptor 2 (HER2) positivity in the global screening programme of the ToGA trial. J Clin Oncol 27 abstract 4556
55.
Zurück zum Zitat Van Cutsem E, Kang Y, Chung H et al (2009) Efficacy results from the ToGA trial: a phase III study of trastuzumab added to standard chemotherapy (CT) in first-line human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer (GC). J Clin Oncol 27 abstract 2409 Van Cutsem E, Kang Y, Chung H et al (2009) Efficacy results from the ToGA trial: a phase III study of trastuzumab added to standard chemotherapy (CT) in first-line human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer (GC). J Clin Oncol 27 abstract 2409
56.
Zurück zum Zitat Joske DJ (2008) Chronic myeloid leukaemia: the evolution of gene-targeted therapy. Med J Aust 189:277–282PubMed Joske DJ (2008) Chronic myeloid leukaemia: the evolution of gene-targeted therapy. Med J Aust 189:277–282PubMed
57.
Zurück zum Zitat Druker BJ (2008) Translation of the Philadelphia chromosome into therapy for CML. Blood 112:4808–4817PubMedCrossRef Druker BJ (2008) Translation of the Philadelphia chromosome into therapy for CML. Blood 112:4808–4817PubMedCrossRef
58.
Zurück zum Zitat Schindler T, Bornmann W, Pellicena P (2000) A structural mechanism for STI-571 inhibition of abelson tyrosine kinase. Science 289:1857–1859CrossRef Schindler T, Bornmann W, Pellicena P (2000) A structural mechanism for STI-571 inhibition of abelson tyrosine kinase. Science 289:1857–1859CrossRef
60.
Zurück zum Zitat Pao W, Miller V, Zakowski M et al (2004) EGF receptor gene mutations are common in lung cancers from “never smokers” and are associated with sensitivity of tumors to gefitinib and erlotinib. Proc Natl Acad Sci USA 101:13306–13311PubMedCrossRef Pao W, Miller V, Zakowski M et al (2004) EGF receptor gene mutations are common in lung cancers from “never smokers” and are associated with sensitivity of tumors to gefitinib and erlotinib. Proc Natl Acad Sci USA 101:13306–13311PubMedCrossRef
61.
Zurück zum Zitat Sordella R, Bell DW, Haber DA et al (2004) Gefitinib-sensitizing EGFR mutations in lung cancer activate anti-apoptotic pathways. Science 305:1163–1167PubMedCrossRef Sordella R, Bell DW, Haber DA et al (2004) Gefitinib-sensitizing EGFR mutations in lung cancer activate anti-apoptotic pathways. Science 305:1163–1167PubMedCrossRef
62.
Zurück zum Zitat Lynch TJ, Bell DW, Sordella R et al (2004) Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 350:2129–2139PubMedCrossRef Lynch TJ, Bell DW, Sordella R et al (2004) Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 350:2129–2139PubMedCrossRef
63.
Zurück zum Zitat Paez JG, Jänne PA, Lee JC et al (2004) EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science 304:1497–1500PubMedCrossRef Paez JG, Jänne PA, Lee JC et al (2004) EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science 304:1497–1500PubMedCrossRef
64.
Zurück zum Zitat Mack GS (2009) FDA holds court on post hoc data linking KRAS status to drug response. Nat Biotechnol 27:110–112PubMedCrossRef Mack GS (2009) FDA holds court on post hoc data linking KRAS status to drug response. Nat Biotechnol 27:110–112PubMedCrossRef
65.
Zurück zum Zitat Amado RG, Wolf M, Peeters M et al (2008) Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer. J Clin Oncol 26:1626–1634PubMedCrossRef Amado RG, Wolf M, Peeters M et al (2008) Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer. J Clin Oncol 26:1626–1634PubMedCrossRef
66.
Zurück zum Zitat Lièvre A, Bachet JB, Le Corre D et al (2006) KRAS mutation status is predictive of response to cetuximab therapy in colorectal cancer. Cancer Res 66:3992–3995PubMedCrossRef Lièvre A, Bachet JB, Le Corre D et al (2006) KRAS mutation status is predictive of response to cetuximab therapy in colorectal cancer. Cancer Res 66:3992–3995PubMedCrossRef
67.
Zurück zum Zitat Nemunaitis J, Clayman G, Agarwala SS et al (2009) Biomarkers predict p53 gene therapy efficacy in recurrent squamous cell carcinoma of the head and neck. Clin Cancer Res 15:7719–7725PubMedCrossRef Nemunaitis J, Clayman G, Agarwala SS et al (2009) Biomarkers predict p53 gene therapy efficacy in recurrent squamous cell carcinoma of the head and neck. Clin Cancer Res 15:7719–7725PubMedCrossRef
69.
Zurück zum Zitat Levy JA (2009) HIV pathogenesis: 25 years of progress and persistent challenges. AIDS 23:147–160PubMedCrossRef Levy JA (2009) HIV pathogenesis: 25 years of progress and persistent challenges. AIDS 23:147–160PubMedCrossRef
70.
Zurück zum Zitat Biswas P, Tambussi G, Lazzarin A (2007) Access denied? The status of co-receptor inhibition to counter HIV entry. Expert Opin Pharmacother 8:923–933PubMedCrossRef Biswas P, Tambussi G, Lazzarin A (2007) Access denied? The status of co-receptor inhibition to counter HIV entry. Expert Opin Pharmacother 8:923–933PubMedCrossRef
71.
Zurück zum Zitat Brunicardi FC, Gibbs RA, Fisher W et al (2009) Overview of the molecular surgeon symposium on personalized genomic medicine and surgery. World J Surg 33:612–614PubMedCrossRef Brunicardi FC, Gibbs RA, Fisher W et al (2009) Overview of the molecular surgeon symposium on personalized genomic medicine and surgery. World J Surg 33:612–614PubMedCrossRef
72.
Zurück zum Zitat Voidonikolas G, Kreml SS, Chen C et al (2009) Basic principles and technologies for deciphering the genetic map of cancer. World J Surg 33:615–629PubMedCrossRef Voidonikolas G, Kreml SS, Chen C et al (2009) Basic principles and technologies for deciphering the genetic map of cancer. World J Surg 33:615–629PubMedCrossRef
73.
Zurück zum Zitat Voidonikolas G, Gingras MC, Hodges S et al (2009) Developing a tissue resource to characterize the genome of pancreatic cancer. World J Surg 33:723–731PubMedCrossRef Voidonikolas G, Gingras MC, Hodges S et al (2009) Developing a tissue resource to characterize the genome of pancreatic cancer. World J Surg 33:723–731PubMedCrossRef
Metadaten
Titel
Overview of the Development of Personalized Genomic Medicine and Surgery
verfasst von
F. Charles Brunicardi
Richard A. Gibbs
David A. Wheeler
John Nemunaitis
William Fisher
John Goss
Changyi Chen
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 8/2011
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-011-1056-0

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