Personalised Medicine – We all know we are different, so why doesn’t medicine?
Personalised medicine research is becoming an increasingly popular and powerful tool across the world. If you haven’t been introduced to the idea of personalised medicine before, the European Council summed it up quite nicely in their?Conclusion on personalised medicine for patients (2015/C 421/03). It states that “it is widely understood that personalised medicine refers to a?medical model?using characterisation of individuals’ phenotypes and genotypes (e.g.?molecular profiling, medical imaging, lifestyle data) for tailoring the right?therapeutic strategy?for the right person at the right time, and/or to determine the?predisposition to disease?and/or to deliver timely and targeted prevention.”
Personalised medicine is moving us away from the traditional ‘one size fits all approach’. Each of us have different biological make ups and physiological processes in our bodies. Not only are we different from each other, but we also change as we age. It is that personal makeup that alters the way diseases form within us, creating different subtypes and consequently altering the effectiveness of medicines.
So why haven’t we been quicker to make personalised medicine more common place?
In 2000, the first draft of the human genome sequences was announced, which provided huge clues into the effectiveness of personalise medicine. We can discover, by analysing and utilising genomic data, new pathways of diseases and are therefore able to change the way we treat certain diseases. Sounds good, doesn’t it? – however this comes at a cost of over ￡2 billion for a single sequence. These costs have hugely hindered the development of personalised medicine and its widespread adoption.
Influential technology
However, advances in technology, specifically in medicine development is helping to solve this problem. As a result, these sequences can now be ascertained at a fraction of the previous cost. Scientists in?Japan are current using the the world’s most powerful Supercomputer?(Fugaku) to mimic the interactions between cells and potential drug molecules. Researcher Kamada Mayumi is convinced that personalised medicine is the way forward, saying:
“Genomic medicine can help us determine the appropriate treatment for the disease, as well as preventive measures. The personalized approach could mean patients will not have to suffer from the unpleasant side effects of?cancer treatments, for instance.”
This is a sentiment shared by a team of experts working on a project called?ChromaDose. ChromaDose is currently developing a drug monitoring tool that will aid personalised dose optimisation for children receiving a commonly used drug to treat childhood lymphomas and leukaemia. In a current trial, nurses who are administering the drug, collect drops of blood and analyse these samples using a ‘ChromaDose Machine’. This machine calculates the patient’s level of exposure to the administered drug within each drop of blood identifying the patient’s pharmacokinetic response.
Almost two thirds of childhood cancer survivors in Europe live with long term side effects of their treatment.?Professor Pamela Kearns?– the co-lead of ChromaDose – highlights the importance of this project in saying that:
“One way to improve the side effect profile of a drug is to be more precise in the dosing. ChromaDose has the potential to allow us to individualise the dose of chemotherapy drugs to maximise effect on the tumour while minimising the side effects.”
Cardiovascular disease is another area that has been hugely benefited from the adoption of personalised medicine. The?Personalized Medicine Coalition?highlight that, traditionally, the primary method for managing heart transplant rejection was invasive heart biopsies. Now a diagnostic test can be simply performed on a blood sample. New research also suggests that ongoing testing may be useful in longer-term patient management by predicting risk of rejection and administering tailored immunosuppressive drug regimes.
Taking preventative measures
The idea of prevention isn’t a concept that medicine researchers have been?interested in historically – previously, the focus has?been?reactive. However, with the rise of personalised medicine, the focus on prevention is becoming ever more popular. A pilot study in the north-east of England is set to?pioneer a personalised medicine approach in respect of?predicting the risk of heart disease. The CEO of Genomics, Sir Peter Donnelly, says in relation to this:
“This represents a real first in personalised medicine. By using genetics we can improve risk prediction for cardiovascular disease so that therapies like statins, as well as lifestyle changes, can be better targeted to the right individuals.
This genomic prevention approach to healthcare could be vital in identifying individuals at risk of developing diseases early, allowing high-risk individuals to make the right lifestyle or medical changes. Even more excitingly, it has been said that approaches like this could also be used to predict risk of other diseases such as “breast, prostate and skin cancers, type 2 diabetes and bipolar disorder.”
Some would say that the notion of personalised medicine is not entirely new – Karl Landsteiner recognised differences in individual patient biology when he identified the ABO blood group system in 1901.?However, it is only in recent years that the true power of personalised medicine has been recognised. As we increase our ability to predict the risk of developing diseases through our understanding?at a molecular level, we increase the?ability to present potential personalised treatment and preventative strategies to patients. The future is certainly looking bright.