By Corine K. Lau, Ph.D., and Jane Z. Kuo, M.D., Ph.D.
President Obama announced the launch of a new Precision Medicine Initiative during his State of the Union address on January 20, 2015.
What does this mean for you and me?
“21st century businesses will rely on American science, technology, research and development. …Tonight, I’m launching a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetes — and to give all of us access to the personalized information we need to keep ourselves and our families healthier.”
– United States President Barack Obama
What is precision medicine?
First, let’s define precision medicine. Precision medicine refers to the medical treatment that is tailored to individuals based on their genetic makeup. However, it does not entail the invention of new drugs, but it focuses on using your DNA data to create a unique profile for therapeutic drugs and medical treatments that can have the greatest effectiveness.
What are the differences between personalized and precision medicine?
You might have heard the terms ‘personalized medicine’ and ‘precision medicine’ being used interchangeably; however, there are some fundamental differences.
According to the National Research Council (NRC), “’precision medicine’ refers to the tailoring of medical treatment to the individual characteristics of each patient. It does not literally mean the creation of drugs or medical devices that are unique to a patient, but rather the ability to classify individuals into subpopulations that differ in their susceptibility to a particular disease, in the biology and/or prognosis of those diseases they may develop, or in their response to a specific treatment.
Preventive or therapeutic interventions can then be concentrated on those who will benefit, sparing expense and side effects for those who will not. Although the term ‘personalized medicine’ is also used to convey this meaning, that term is sometimes misinterpreted as implying that unique treatments can be designed for each individual. For this reason, the [NRC] Committee thinks that the term ‘precision medicine’ is preferable to ‘personalized medicine.’”
How will precision medicine affect the medical community and influence my visits to the doctor?
Conventional medical diagnoses and treatments have been based mostly on clinical symptoms and pathology, but there is an increasing shift in paradigm towards a new type of medical diagnosis, one that is classified based on molecular-diagnosis, not organ-based diagnosis.
For example, breast cancer has been traditionally defined as cancer that arises from the breast (organ-based classification). With advances in molecular diagnostics, there is a shift toward grouping cancers together with similar molecular driver mutations (molecular-based classification) so that these treatments may be tailored or more precise for the patient.
Current FDA-approved drugs on the market have been based on the ‘one-size-fits-all’ model, meaning the drugs are meant to treat everyone with the same conditions the same way. Each individual is unique and special, so why should drug treatments be the same for all?
Precision medicine is also applicable in pharmacogenomics studies where a number of on-going clinical trials are currently investigating how a group of patients with similar genetic background might respond to a particular drug. Results from these studies would then help a physician determine what type of treatment is most appropriate for you. With precision medicine, your doctors might suggest genetic testing for the diagnosis, treatment, and monitoring of different diseases.
What is the role of the government in this?
While the details on the Precision Medicine Initiative have not been released, we foresee the Initiative assists in advancing precision medicine in several ways.
First, there might be increased funding from the government to facilitate scientific research and provide resources for the scientific and medical communities.
Second, challenges involving policy, data security, and regulation must first be addressed before any wider implementation into clinical medicine.
Third, public awareness and education are powerful components in the success in many new medical treatments. As a consumer, finding out all the relevant information from reliable sources and discussing with your health care professional are crucial for making the best, informed decision.
In an era of information integrated with technology, genomics and medicine, it is to our advantage to use this information in a sensible way to help advance medicine and medical treatments.
Precision medicine is not an isolated process discovered by a few scientists or drug companies trying to tap into your DNA profile. Precision medicine is a joint effort between the government (funding and personal data security), research institutes (research and development), biotechnology and biopharmaceutical companies and health care providers. All different entities have to work together with one goal: to provide the best health care and medical treatments for you.