Current clinical trial approaches in rare disease test one drug on one indication defined by a clinical phenotype. For targeted drugs, grouping patients by molecular etiology would make much more sense.
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References
- 1
Mort, M., Ivanov, D., Cooper, D.N. & Chuzhanova, N.A. Hum. Mutat. 29, 1037–1047 (2008).
- 2
Peltz, S.W., Morsy, M., Welch, E.M. & Jacobson, A. Annu. Rev. Med. 64, 407–425 (2013).
- 3
Auld, D.S., Thorne, N., Maguire, W.F. & Inglese, J. Proc. Natl. Acad. Sci. USA 106, 3585–3590 (2009).
- 4
McElroy, S.P. et al. PLoS Biol. 11, e1001593 (2013).
- 5
Wilschanski, M. et al. Eur. Respir. J. 38, 59–69 (2011).
- 6
Kuschal, C., Digiovanna, J.J., Khan, S.G., Gatti, R.A. & Kraemer, K.H. Proc. Natl. Acad. Sci. USA 110, 19483–19488 (2013).
- 7
Du, L. et al. J. Exp. Med. 206, 2285–2297 (2009).
- 8
Nudelman, I. et al. J. Med. Chem. 52, 2836–2845 (2009).
- 9
Dietz, H.C. N. Engl. J. Med. 363, 852–863 (2010).
- 10
Linde, L. & Kerem, B. Trends Genet. 24, 552–563 (2008).
- 11
Keeling, K.M. & Bedwell, D.M. Wiley Interdiscip. Rev. RNA 2, 837–852 (2011).
- 12
Kuzmiak, H.A. & Maquat, L.E. Trends Mol. Med. 12, 306–316 (2006).
- 13
Keeling, K.M. et al. PLoS ONE 8, e60478 (2013).
- 14
Lindquist, S.L. & Kelly, J.W. Cold Spring Harb. Perspect. Biol. 3, a004507 (2011).
- 15
Amaral, M.D. & Farinha, C.M. Curr. Pharm. Des. 19, 3497–3508 (2013).
- 16
Parenti, G. EMBO Mol. Med. 1, 268–279 (2009).
- 17
Bemporad, F. & Chiti, F. Chem. Biol. 19, 315–327 (2012).
- 18
Balch, W.E., Morimoto, R.I., Dillin, A. & Kelly, J.W. Science 319, 916–919 (2008).
- 19
Wang, F., Song, W., Brancati, G. & Segatori, L. J. Biol. Chem. 286, 43454–43464 (2011).
- 20
Yang, C. et al. Proc. Natl. Acad. Sci. USA 111, 249–254 (2014).
- 21
Mu, T.W., Fowler, D.M. & Kelly, J.W. PLoS Biol. 6, e26 (2008).
- 22
Garber, K. Nat. Biotechnol. 31, 189 (2013).
- 23
Quintana-Gallego, E., Delgado-Pecellín, I. & Calero Acuña, C. Arch. Bronconeumol. 50, 146–150 (2014).
- 24
Myerowitz, R. Hum. Mutat. 9, 195–208 (1997).
- 25
Hruska, K.S., LaMarca, M.E., Scott, C.R. & Sidransky, E. Hum. Mutat. 29, 567–583 (2008).
- 26
Mossé, Y.P. et al. Lancet Oncol. 14, 472–480 (2013).
- 27
Pichavant, C. et al. Mol. Ther. 19, 830–840 (2011).
- 28
Hoffman, E.P. & Connor, E.M. Discov. Med. 16, 233–239 (2013).
- 29
Nakamura, K., Hattori, K. & Endo, F. Am. J. Med. Genet. C. Semin. Med. Genet. 157, 63–71 (2011).
- 30
Kulkarni, A. & Wilson, D.M. III. Am. J. Hum. Genet. 82, 539–566 (2008).
- 31
Xu, M. et al. J. Biol. Chem. 287, 39349–39360 (2012).
- 32
Anderson, S.L. & Rubin, B.Y. Biochem. Biophys. Res. Commun. 336, 150–156 (2005).
- 33
Axelrod, F.B. et al. Pediatr. Res. 70, 480–483 (2011).
- 34
Hims, M.M. et al. J. Mol. Med. (Berl.) 85, 149–161 (2007).
- 35
Wang, G.S. & Cooper, T.A. Nat. Rev. Genet. 8, 749–761 (2007).
- 36
Boone, N. et al. Hum. Mutat. 33, 530–540 (2012).
- 37
Rymond, B. Nat. Chem. Biol. 3, 533–535 (2007).
- 38
Kazantsev, A.G. & Thompson, L.M. Nat. Rev. Drug Discov. 7, 854–868 (2008).
- 39
Medina, M., Garrido, J.J. & Wandosell, F.G. Front. Mol. Neurosci. 4, 24 (2011).
- 40
Cullen, V. et al. Ann. Neurol. 69, 940–953 (2011).
- 41
Appelqvist, H., Wäster, P., Kågedal, K. & Öllingerm, K. J. Mol. Cell Biol. 5, 214–226 (2013).
- 42
Kleta, R. & Gahl, W.A. Expert Opin. Pharmacother. 5, 2255–2262 (2004).
- 43
Tuchman, M. et al. Pediatr. Res. 64, 213–217 (2008).
- 44
Huang, R. et al. Sci. Transl. Med. 3, 80ps16 (2011).
Acknowledgements
P.J.B. is also a Program Director in the Division of Metabolism and Health Effects, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA.
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Brooks, P., Tagle, D. & Groft, S. Expanding rare disease drug trials based on shared molecular etiology. Nat Biotechnol 32, 515–518 (2014). https://doi.org/10.1038/nbt.2924
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