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To The Editor: In his Commentary on health care in the age of genetic medicine, Dr Evans¹ highlights the advent of individualized medicine as a "threshold that is so monumental it mandates changes in the structure of health care delivery" and notes that "[d]riven by advances in genomics, emerging insight into each individual's unique susceptibility to disease promises to transform patient care."¹ He draws attention to technology that is also relevant to the Commentary by Drs Hudis and Modi,² in which they note that postoperative adjuvant chemotherapy initially "required a shift in thinking . . . because it included the use of potentially toxic drugs in patients, some of whom were presumably already cured of malignancy."²

Adjuvant therapy (and neoadjuvant therapy, according to Drs Hudis and Modi) has been shown to provide improvement in prognosis for surgical patients.³ However, not all patients require such therapy; some patients who receive neoadjuvant therapy achieve no improvement . . . [Full Text of this Article]

George L. Anesi, BS
george.anesi@case.edu
Case Western Reserve University
School of Medicine
Cleveland, Ohio

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Health Care in the Age of Genetic Medicine
James P. Evans
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Genetically Guided Choices for Chemotherapy—Reply
James P. Evans
JAMA. 2008;299(13):1544.
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Genetically Guided Choices for Chemotherapy—Reply
Clifford A. Hudis and Shanu Modi
JAMA. 2008;299(13):1544.
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