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The International Journal of the Royal Society of Thailand
Volume XI - 2019

are able to precisely adjust dosage or avoid using susceptible drugs. A severe form
of adverse drug reaction— Stevens-Johnson syndrome—is possible to forecast by
recent genomic technologies. The presence of some mutations in the BRCA1/2

gene predisposes an individual to have higher cancer risk; therefore, an efficient
preventive care is precisely given to one who has familial history of ovarian or
breast carcinoma.

Advanced imaging platforms such as positron emission tomography
(PET), single-photon emission computed tomography (SPECT) and magnetic
resonance imaging (MRI) integrated with deep learning algorithm or artificial
intelligence become new standards for medical diagnosis. By using radio-
antibody- or quantum-dot-tagged molecules, a radiologist is able to accurately
localize abnormal cells or tissues, and can deliver a custom-designed drug to
its target. Together with high-throughput genomic or phenotypic screening,
biologics products including therapeutic antibody, viral vector-based gene
therapy or vaccine as well as advanced therapy medicinal products (ATMP)
are designed and properly delivered to each patient.

Currently, there are a number of products available in market. For instance,
a personalized biologics regimen known as radioactive 131 I -tositumomab—
an IgG 2a lamda monoclonal antibody targeting CD20 antigen—has been
approved for the treatment of relapsed chemotherapy-refractory non-Hodgkin
lymphoma (Davies, 2007). In addition, a severe genetic disease so-called X-linked
hypophosphatemia and tumor-induced osteomalacia can be mitigated by
burosumab (Zhang et al., 2016), a monoclonal antibody against fibroblast growth
factor 23 (FGF-23), which is a bone-derived hormone for regulating intestinal
calcium absorption, bone metabolism and renal phosphate excretion
(Chanpaisaeng et al., 2021). Recently, a viral vector-based drug named voretigene

neparvovec have been approved to treat Leber congenital amaurosis, a rare
inherited disease with a loss of vision (Russell et al., 2017).
The presence volume of the International Journal of the Royal Society of
Thailand thus focuses on advances in precision medicine pertaining to diagnosis
and treatments of neoplastic, neurological, infectious, renal and bone diseases.
Relevant preventive medicine and medical ethics are also elaborated. Contributions

of digital technology and machine learning are extensively discussed as they are
essential for the future of “digital health”.

2 Advances in precision medicine

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