Authors: Martha Powell, Future Science Group
In line with our focus on precision medicine, learn more about this approach and what the future of healthcare might hold as we take a look at some of the frequently asked questions around this topic.
What is precision medicine?
Precision medicine is an approach to disease treatment and prevention that takes into account individual variations in genetics, environment and lifestyle. By providing the right treatment, to the right patient at the right time, this approach aims to achieve better outcomes in disease management or prevention by moving away from a ‘one-size-fits-all’ approach.
When is precision medicine used?
Although the term precision medicine is relatively new, some examples are currently seen in health and medicine. For instance, when a blood transfusion is given an individual is not given blood from a randomly selected donor, but the recipient’s blood type is matched to the donor in order to reduce the risk of complications. Moreover, at the European Congress of Clinical Microbiology and Infectious Diseases 2019 (13–16 April, Amsterdam, the Netherlands) Evelina Tacconelli (University Hospital of Tübingen, Germany) argued that antibiotic prescriptions are per se a precision approach – accounting for patient factors, bacterial factors, drug factors and the impact on society.
Researchers now hope that this approach will expand to many areas of health and healthcare in coming years – and oncology is a particular focus. Currently, if an individual is diagnosed with cancer, they often receive the same treatment as others who have the same stage and type of tumor; however, different responses to treatment are seen. Now it is being understood that genetic and phenotypic changes in tumors, in addition to patient factors, could be responsible for differing drug responses, suggesting that cancer treatment could be tailored to the genetic changes in each cancer case.
Why is precision medicine important?
The individual approach that precision medicine brings will allow doctors and researchers to predict more accurately which treatment and prevention strategies might be more successful in certain groups of people. This is in contrast to the ‘one-size-fits-all’ approach currently used in medicine.
Over the coming years, advances in genetics and the growing availability of electronic health data present an opportunity to make precise personalized patient care a clinical reality.
Will precision medicine improve population health?
As mentioned, precision medicine would see a future when genetic tests will help decide which treatments a patient is most likely to respond to, sparing the patient from receiving treatments that are not likely to help; something that is clearly of benefit to the individual. In addition, other benefits of precision medicine could be to ensure that we avoid prescribing drugs with predictable side effects, a reduction in the time and cost involved in finding an efficacious treatment and also the lower failure rate of pharmaceutical clinical trials.
Is ‘big data’ important in precision medicine?
Precision medicine is ultimately powered by patient data. The health records and the genomic information of both patients and healthy volunteers are vital to understand the demographics of individuals that might respond differently to different treatments.
Although precision medicine currently individualizes treatment primarily on the basis of genomic testing, for example in oncology the Oncotype DX test to inform breast cancer treatment, there are several other promising technologies are being developed that could further subsect patients, from techniques combining spectrometry and computational power to real-time imaging of drug effects in the body. Moreover, ever-improving understanding of the microbiome presents another opportunity to tailor disease treatment and preventatives to individuals.
What’s the difference between precision medicine and personalized medicine?
The two terms are sometimes used interchangeably. The term personalized medicine was defined synonymously, however, it is now not the preferred term as some argue that physicians have always treated patients on a personalized level. For example, the personal approach is an inherent part of the doctor–patient relationship, and although personalization is a central aspect of precision medicine, it is not a new invention.
However, the definitive concept is using new biomedical information to add an additional understanding beyond observable clinical signs and symptoms – and it has been argued that the term precision medicine represents this better.
What is the Precision Medicine Initiative?
The Precision Medicine Initiative was established in 2015 during Barack Obama’s presidency, aiming to create a program with both long- and short-term goals to further our understanding of the impact of genetics, environment and lifestyle on an individual’s health.
The short-term goals of the Initiative focus on implementing the philosophies and techniques used in precision medicine in the field of oncology. The long-term goal is to expand precision medicine to become applicable to all diseases and medical conditions.
The All of Us program was developed by the National Institutes of Health (MD, USA) to meet this long-term goal, with the objective of collecting data from over 1 million individuals, including genetic and biological samples, alongside data concerning their lifestyles and environment.
The All of Us program launched in 2016, receiving an initial US $130 million in funding – a figure that has since increased to over US $290 million. The program opened enrolment in May 2018, allowing any adult over the age of 18 that is able to provide consent and is not incarcerated to participate.
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