Synthesis of Emergent Biotechnologies into Future CPG

The focus of this book is to present emergent biotechnologies and then forecast their impact on future clinical practice guidelines (CPG). Four clinical cases have been presented at the beginning of this book in which current CPG recommendations failed to provide optimal management. Knowledge gaps, which cannot be solved by interpolation of current information, account for shortcomings in risk stratification and design of therapies that address proximate molecular pathogenic events. CPG methodology now allows for the rapid incorporation of new information, particularly molecular medicine and imaging techniques, to close these knowledge gaps. A complex molecular pathogenesis may be addressed by personalized single- or multimodality approaches involving targeted therapies, new chemotherapeutics, new radiopharmaceuticals, image-guided radiotherapy, or novel surgical procedures. Advances in bioinformatics will facilitate the compilation, analysis, and dissemination of this information. Primary and secondary prevention strategies for patients “at risk” based on genetic studies may also include targeted therapies. CPG recommendations can contain cascades in which modifications are based on resource availability in certain geographic areas or clinical settings around the world. Ultimately, being aware of potential innovations will encourage referrals for clinical investigation and earlier adoption of safe and effective biotechnologies when they become more widely available.