We are all familiar with a trip to the doctor — which begins with a standard procedure of checking our vital stats for any physical abnormalities in our system, followed by diagnosing a disease, and usually ends in the prescription of a few ‘commonly used’ medications. Such methods, which aim to treat a disease rather than the patient, are slowly fading out, giving rise to new and improved treatment designs.
A surge in global incidences of cancer and numerous chronic and infectious diseases have shifted the priority of scientists and researchers worldwide to understand the underlying cause of such ailments. Aided by advancements in medical sciences and technology, precision medicine has seen a rapid growth worldwide. In its 2017 report, Allied Market Research valued the market at $3.5 trillion in 2016 and estimated it to reach $7.7 trillion by 2023, with a CAGR of 11.9% from 2017-2023. Such a high market value is a testament to the rapid advancement of this field, which hopes to provide customized treatment not only for curing ailments but also for preventing them in the future.
Precision Medicine and its Advantages
Precision medicine works on the fundamental principle that a particular disease gives rise to different physical symptoms in different individuals, based on their genome structure, lifestyle and environmental conditions. For example, two people of different ethnicity may not respond in the same way to a drug treatment. The ‘medical model‘ of precision medicine aims to customize the treatment based on the three above mentioned governing factors, which characterizes an individual’s response to the disease.
The use of system biology and panomics aids this process by diagnosing the illness at a molecular level. Once the cause is determined, customized medication could be prescribed to them. Such personalized medicine moves from the ‘one-size-fits-all’ model that doctors have previously adhered to.
While it might be expensive to customize medicine for each individual, gathering the genetic makeup of individuals could be useful in classifying them into groups, notes khn.org. Such groups, then, will have their own customized treatment. Collecting genomic information of the population will also aid population health studies in the future, which can help prevent diseases at an early stage.
Precision medicine can also reduce the cost of treatment by decreasing repetitive administration of medicine and mitigating the side-effects associated with them. Treating an ailment on a molecular level will help biologists understand the underlying cause behind their occurrence and correspondingly develop medicine to eradicate them completely. Genetic targeting can drive the development of drugs rather than the long and arduous trial and error procedure.
Advancements in Precision Medicine
Personalized treatment was initially developed to aid the field of oncology. Around 20 years ago, targeted therapy was suggested for the treatment of HER-2 positive breast cancer. Since then, medical professionals have realized the importance of precision medicine in the treatment of cancer. Dr. Suzanne Kamal-Reid, chief of clinical laboratory genetics at University of Toronto, expressed that “knowing the genetic composition of certain forms of leukemia is proving to be very effective in identifying specific changes that occur during its propagation”.
In lung cancer and melanoma patients, genomic profiling of solid tumors can effectively determine the eligibility criteria of patients to enter potentially less toxic and more tolerable forms of remedies than chemotherapy. Initially developed to treat cancer, precision medicine now has moved on to other fields like immunology, respiratory disorders and infections.
The burgeoning field of precision medicine has also seen some significant developments in the past decade, points out nih.gov. Scientists have placed importance into researching biomarkers, with the journal “Advances in Precision Medicine” describing biomarkers as its key focus. Studies have recently identified biomarkers that explain the phenomenon of long term learning and could aid the understanding of symptoms like ADHD and ADD.
The therapeutic field of pharmacogenomics, responsible for identifying genes that affect drug response in patients, could help link a patient’s genetic profile to their variable drug responses. This could have profound implications in the management of gynecological and neurological disorders. Data obtained from blood transcriptomics and metabolomics are being used to develop robust models that can aid the understanding of immune system and pathways, and potentially treat diseases pertaining to them.
Integrating AI and Blockchain technologies into Precision Medicine
Although the benefits of precision medicine in the field of healthcare are immense, there are a few constraints regarding its implementation. The major issue arises while handling the enormous data on a population’s genome structure. Blockchain technology, which works on distributed networks and shared ledgers can be used to ensure the data is secured and used ethically, while barring mishandling. As the data needs to be shared across different platforms, Blockchain technology can also ensure security surrounding the genetic information of thousands of people.
Artificial Intelligence (AI) can be implemented to analyze patterns in the data and provide insights to medical professionals regarding the condition of an individual. Genome sequencing can be expedited using AI as well. AI can also be used for clustering and segregating the population into groups that can aid the production of customized medicine.
Despite challenges in its implementation, Precision medicine is all set to go mainstream and potentially revolutionize the healthcare industry. Richard Tsai of Inspire, a leading social network platform for health, says that “precision medicine will become the bedrock and foundation of science, medicine, and potentially even shape and guide our healthcare administrative architecture”. Despite such promise, the field lacks funding opportunities from the government, private sector and beneficiaries.
In 2015, Barrack Obama dedicated $215 million to the Precision Medicine Initiative — which included the idea to map the DNA of 1 million Americans, research genetic causes of cancer and evaluate new diagnostic drugs. Advances in gene sequencing (using AI) can lower the costs incurred while genetically mapping a population. As most genetic profiling occurs in clinical trial environment, access to the general population will increase its knowledge base.