Precision Medicine: The Future of Patient Care?
Precision medicine is an emerging field of medicine that aims to tailor disease treatment to people’s genes, environment, and lifestyle. This approach considers pharmacogenomics—how genes can affect a person’s response to a drug— which, in cancer treatments, for example, can also involve sequencing tumors to understand their biology and potentially find specific mutations to target. By tailoring a treatment plan based on the unique biology of the patient, precision medicine is revolutionizing the one-size-fits-all approach to medicine and allowing for better outcomes by promising targeted treatments for every patient.
Precision medicine has already revealed itself to be an effective tool against cancer. In a recent clinical trial for the treatment of papillary craniopharyngioma (PCP), a rare brain cancer, doctors sequenced individual tumors from patients and found mutations in two proteins involved in cell growth. Given that Genentech already had two cancer drugs targeting these specific genes, but for the treatment of melanoma, the company recently completed a phase 2 clinical trial of them in PCP patients with these mutations. The drugs shrank tumors by over 90% on average. While participants had the option to undergo surgery and radiation after the drug treatment, seven patients refused and, even after two years, six of them still had no tumor progression. Although there is still work to be done to refine this treatment, this remarkable initial outcome reveals how powerful a tool precision medicine is and the potential that it has to change the standard of care for cancers and rare diseases.
However, implementing precision medicine on a large scale faces several challenges. First, the cost of this approach can be extremely high. In addition to the exorbitant costs of developing novel drugs to treat genetic or molecular variations, advanced technology is required to sequence large amounts of DNA from patients in the first place. Although Medicare does currently cover some genomics-based diagnostic tools for ovarian and breast cancers, patients will likely have to consider whether their insurance will cover DNA sequencing and targeted drug treatments for their specific cancer. Additionally, after sequencing and finding a specific genetic variation, there is no guarantee that a drug exists to target that mutation yet. Given that targeted disease therapies are so rare, the discovery and development of these specific therapies is an exciting, but difficult, field in drug discovery. One way that many companies are now finding novel targets and designing targeted drugs is through advanced technology such as AI and machine learning. This technology can speed up the process of analyzing interactions between gene targets and drugs, while also optimizing drug design and efficacy. Accelerated drug discovery and development through AI is an exciting field that can help to overcome this lack of targeted drugs and reduce the barriers, and potentially the costs, of precision medicine.
In the long-term, precision medicine could truly change the status quo of cancer and rare disease treatments by integrating genomics with disease diagnosis and treatment. This will lead to improved outcomes for patients and better quality of care. The rise of precision medicine also opens up interesting conversations around improving biotechnology within genomic sequencing, biopsies, biomarker identification, and drug development. It will be exciting to watch all of these fields improve, grow, and interact.