by having a detailed account of an individual's dna sequence, their genome can then be compared to a reference genome, like that of the human genome project, to assess the existing genetic variations that can account for possible diseases. a number of private companies, such as 23andme, navigenics, and illumina, have created direct-to-consumer genome sequencing accessible to the public. having this information from individuals can then be applied to effectively treat them. an individual's genetic make-up also plays a large role in how well they respond to a certain treatment, and therefore, knowing their genetic content can change the type of treatment they receive. an aspect of this is pharmacogenomics, which uses an individual's genome to provide a more informed and tailored drug prescription. often, drugs are prescribed with the idea that it will work relatively the same for everyone, but in the application of drugs, there are a number of factors that must be considered. the detailed account of genetic information from the individual will help prevent adverse events, allow for appropriate dosages, and create maximum efficacy with drug prescriptions. for instance, warfarin is the fda approved oral anticoagulant commonly prescribed to patients with blood clots. due to warfarin's significant interindividual variability in pharmacokinetics and pharmacodynamics, its rate of adverse events is among the highest of all commonly prescribed drugs. however, with the discovery of polymorphic variants in cyp2c9 and vkorc1 genotypes, two genes that encode the individual anticoagulant response, physicians can use patients' gene profile to prescribe optimum doses of warfarin to prevent side effects such as major bleeding and to allow sooner and better therapeutic efficacy. the pharmacogenomic process for discovery of genetic variants that predict adverse events to a specific drug has been termed toxgnostics. an aspect of a theranostic platform applied to personalized medicine can be the use of diagnostic tests to guide therapy. the tests may involve medical imaging such as mri contrast agents (t1 and t2 agents), fluorescent markers (organic dyes and inorganic quantum dots), and nuclear imaging agents (pet radiotracers or spect agents). or in vitro lab test including dna sequencing and often involve deep learning algorithms that weigh the result of testing for several biomarkers. in addition to specific treatment, personalised medicine can greatly aid the advancements of preventive care. for instance, many women are already being genotyped for certain mutations in the brca1 and brca2 gene if they are predisposed because of a family history of breast cancer or ovarian cancer. as more causes of diseases are mapped out according to mutations that exist within a genome, the easier they can be identified in an individual. measures can then be taken to prevent a disease from developing. even if mutations were found within a genome, having the details of their dna can reduce the impact or delay the onset of certain diseases. having the genetic content of an individual will allow better guided decisions in determining the source of the disease and thus treating it or preventing its progression. this will be extremely useful for diseases like alzheimer's or cancers that are thought to be linked to certain mutations in our dna. a tool that is being used now to test efficacy and safety of a drug specific to a targeted patient group/sub-group is companion diagnostics. this technology is an assay that is developed during or after a drug is made available on the market and is helpful in enhancing the therapeutic treatment available based on the individual. these companion diagnostics have incorporated the pharmacogenomic information related to the drug into their prescription label in an effort to assist in making the most optimal treatment decision possible for the patient. an overall process of personalized cancer therapy. genome sequencing will allow for a more accurate and personalized drug prescription and a targeted therapy for different patients. drug development and usage having an individual's genomic information can be significant in the process of developing drugs as they await approval from the fda for public use. having a detailed account of an individual's genetic make-up can be a major asset in deciding if a patient can be chosen for inclusion or exclusion in the final stages of a clinical trial. being able to identify patients who will benefit most from a clinical trial will increase the safety of patients from adverse outcomes caused by the product in testing, and will allow smaller and faster trials that lead to lower overall costs. in addition, drugs that are deemed ineffective for the larger population can gain approval by the fda by using personal genomes to qualify the effectiveness and need for that specific drug or therapy even though it may only be needed by a small percentage of the population., physicians commonly use a trial and error strategy until they find the treatment therapy that is most effective for their patient. with personalized medicine, these treatments can be more specifically tailored by predicting how an individual's body will respond and if the treatment will work based on their genome. this has been summarized as "therapy with the right drug at the right dose in the right patient." such an approach would also be more cost-effective and accurate. for instance, tamoxifen used to be a drug commonly prescribed to women with er+ breast cancer, but 65% of women initially taking it developed resistance. after research by people such as david flockhart, it was discovered that women with certain mutation in their cyp2d6 gene, a gene that encodes the metabolizing enzyme, were not able to efficiently break down tamoxifen, making it an ineffective treatment for them. women are now genotyped for these specific mutations to select the most effective treatment. screening for these mutations is carried out via high-throughput screening or phenotypic screening. several drug discovery and pharmaceutical companies are currently utilizing these technologies to not only advance the study of personalised medicine, but also to amplify genetic research. alternative multi-target approaches to the traditional approach of "forward" transfection library screening can entail reverse transfection or chemogenomics. pharmacy compounding is another application of personalised medicine. though not necessarily using genetic information, the customized production of a drug whose various properties (e.g. dose level, ingredient selection, route of administration, etc.) are selected and crafted for an individual patient is accepted as an area of personalised medicine (in contrast to mass-produced unit doses or fixed-dose combinations). computational and mathematical approaches for predicting drug interactions are also being developed. for example, phenotypic response surfaces model the relationships between drugs, their interactions, and an individual's biomarkers. one active area of research is efficiently delivering personalized drugs generated from pharmacy compounding to the disease sites of the body. for instance, researchers are trying to engineer nanocarriers that can precisely target the specific site by using real-time imaging and analyzing the pharmacodynamics of the drug delivery. several candidate nanocarriers are being investigated, such as iron oxide nanoparticles, quantum dots, carbon nanotubes, gold nanoparticles, and silica nanoparticles. alteration of surface chemistry allows these nanoparticles to be loaded with drugs, as well as to avoid the body's immune response, making nanoparticle-based theranostics possible. nanocarriers' targeting strategies are varied according to the disease. for example, if the disease is cancer, a common approach is to identify the biomarker expressed on the surface of cancer cells and to load its associated targeting vector onto nanocarrier to achieve recognition and binding; the size scale of the nanocarriers will also be engineered to reach the enhanced permeability and retention effect (epr) in tumor targeting. if the disease is localized in the specific organ, such as the kidney, the surface of the nanocarriers can be coated with a certain ligand that binds to the receptors inside that organ to achieve organ-targeting drug delivery and avoid non-specific uptake. despite the great potential of this nanoparticle-based drug delivery system, the significant progress in the field is yet to be made, and the nanocarriers are still being investigated and modified to meet clinical standards. theranostics theranostics is a personalised approach to treating cancer, using similar molecules for both imaging (diagnosis) and therapy; the term is a portmanteau of "therapeutics" and "diagnostics". it is most commonly applied to the field of nuclear medicine where radionuclides (either gamma or positron emitters) are attached to molecules for spect or pet imaging, or to beta, alpha or auger electron emitters for radiotherapy. one of the earliest examples is the use of radioactive iodine for treatment of patients with thyroid cancer. other examples include radio-labelled anti-cd20 antibodies (e.g. bexxar) for treating lymphoma, radium-223 for treating bone metastases, lutetium-177 dotatate for treating neuroendocrine tumours and lutetium-177 psma for treating prostate cancer. the most commonly used reagent is fluorodeoxyglucose, using the isotope fluorine-18 radiotheranostics radiotheranostics is a subspecialty of theranostics using similar pharmaceuticals for both imaging and therapy with radiation. the pharmaceutical or mechanism of localization/action remains the same with the radionuclide being interchangeable with the diagnostic radiopharmaceutical often being a gamma or pet emitter, and the therapeutic radiopharmaceutical often being a beta or alpha emitter. the terms theranostics and theragnostics are interchangeable terms with both having the same meaning and intent. similar terms radiotheranostics and radiotheragnostics are interchangeable as well. the terms are derived from the greek words "thera" from "therapeia" meaning healing or to heal, e.g. therapy, and "gnostic" from greek "gnos" meaning knowledge and to know, e.g. diagnostic. dosimetry is commonly used to guide clinicians for a personalised/precision therapeutic amount for each patient. respiratory proteomics the preparation of a proteomics sample on a sample carrier to be analyzed by mass spectrometry respiratory diseases affect humanity globally, with chronic lung diseases (e.g., asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, among others) and lung cancer causing extensive morbidity and mortality. these conditions are highly heterogeneous and require an early diagnosis. however, initial symptoms are nonspecific, and the clinical diagnosis is made late frequently. over the last few years, personalized medicine has emerged as a medical care approach that uses novel technology aiming to personalize treatments according to the particular patient's medical needs. in specific, proteomics is used to analyze a series of protein expressions, instead of a single biomarker. proteins control the body's biological activities including health and disease, so proteomics is helpful in early diagnosis. in the case of respiratory disease, proteomics analyzes several biological samples including serum, blood cells, bronchoalveolar lavage fluids (bal), nasal lavage fluids (nlf), sputum, among others. the identification and quantification of complete protein expression from these biological samples are conducted by mass spectrometry and advanced analytical techniques. respiratory proteomics has made significant progress in the development of personalized medicine for supporting health care in recent years. for example, in a study conducted by lazzari et al. in 2012, the proteomics-based approach has made substantial improvement in identifying multiple biomarkers of lung cancer that can be used in tailoring personalized treatments for individual patients. more and more studies have demonstrated the usefulness of proteomics to provide targeted therapies for respiratory disease. cancer genomics over recent decades cancer research has discovered a great deal about the genetic variety of types of cancer that appear the same in traditional pathology. there has also been increasing awareness of tumour heterogeneity, or genetic diversity within a single tumour. among other prospects, these discoveries raise the possibility of finding that drugs that have not given good results applied to a general population of cases may yet be successful for a proportion of cases with particular genetic profiles. "personalized onco-genomics" is the application of personalized medicine to cancer genomics, or "oncogenomics". high-throughput sequencing methods are used to characterize genes associated with cancer to better understand disease pathology and improve drug development. oncogenomics is one of the most promising branches of genomics, particularly because of its implications in drug therapy. examples of this include: trastuzumab (trade names herclon, herceptin) is a monoclonal antibody drug that interferes with the her2/neu receptor. its main use is to treat certain breast cancers. this drug is only used if a patient's cancer is tested for over-expression of the her2/neu receptor. two tissue-typing tests are used to screen patients for possible benefit from herceptin treatment. the tissue tests are immunohistochemistry(ihc) and fluorescence in situ hybridization(fish) only her2+ patients will be treated with herceptin therapy (trastuzumab) tyrosine kinase inhibitors such as imatinib (marketed as gleevec) have been developed to treat chronic myeloid leukemia