Personalised reimbursement: a risk-sharing model for biomarker-driven treatment of rare subgroups of cancer patients
S B van Waalwijk van Doorn-Khosrovani  A Pisters-van Roy L van Saase  M van der Graaff  J Gijzen  S Sleijfer  L R Hoes J M van Berge Henegouwen  H van der Wijngaart  D L van der Velden ... Show more
Annals of Oncology, Volume 30, Issue 5, May 2019, Pages 663–665, https://doi.org/10.1093/annonc/mdz119
Published: 26 April 2019
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Issue Section: Editorials
Precision medicine in oncology is based on the premise that every tumour is unique and therefore requires a thorough molecular analysis to identify the best possible targeted treatment. In general, access to precision medicine, especially outside an approved indication is challenging. There are several barriers and concerns. Although the paradigm of precision medicine in cancer is to target a specific genetic aberration, there is uncertainty regarding effectiveness for every biomarker–tumour–drug combination. Various other factors, such as post-transcriptional modifications, protein expression, tissue context, heterogeneity of the tumour and its microenvironment, variations in patient characteristics, and prior treatments also contribute to uncertainty of treatment outcome....

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