Personalized medicine (PM), the current buzzword in medicine, involves the use of tailor-made interventions based upon the environmental landscape and genetic makeup of the patient to obtain the most effective disease outcome – a complete cure. Also known as individualized or precision medicine, PM envisages that a generic therapeutic regimen will not be efficacious because of the tremendous variability in the genetic makeup of patients, thereby rendering patients to respond differently to conventional therapies.
Why the Need For Personalized Medicine?
A personalized therapeutic regimen holds promise for better treatment choices and follow-up care for patients. Ironically, the idea of personalized therapy has been the cornerstone of eastern medicine and has only recently been gaining impetus in western medicine for several diseases including cancer, cardiac diseases, autoimmune diseases and neurological diseases.
A generalized approach to therapy is less than ideal because of the range of clinical responses in patients ranging from a complete cure to no response. Usually, this is because the genetic makeup of each patient is different and this dictates how an individual will respond to a particular therapy. The design of a personalized regimen is advantageous because it takes into consideration the measurement of disease predisposition, screening and early diagnosis, prognosis assessment, pharmacogenomics measurements and disease course monitoring.
Current Perspectives and Advances
Recent developments in the field of genomics, transcriptomics and proteomics have led to a better understanding of the disease a patient is suffering from and has enabled the clinician to not only prescribe drugs that will be most effective in that milieu but also better biomarkers to track prognosis. For example, for patients diagnosed with metastatic melanoma with the V600E driver mutation in BRAF, the use of BRAF kinase inhibitors showed a significant increase in progression-free survival as compared to a more conventional drug called dacarbazine. A similar approach involving the use of tyrosine kinase inhibitors have been effective for the treatment of non-small cell lung carcinomas. Rheumatoid arthritis and Type 1 diabetes are other diseases in which personalized therapies are having favorable impacts.
While PM is slowly but surely becoming a paradigm in current treatment approaches, it brings with it a considerable number of challenges. These include the high cost of implementation because of the additional diagnostics needed. Currently, most insurance plans do not cover these procedures which leaves the burden of this cost on the patient. However, polices are being formulated to address this issue. Another challenge is the lack of comprehensive information regarding diagnostic and prognostic markers for heterogenetic diseases, wherein there is tremendous variability among patients. Additionally, a personalized therapeutic regimen can be better adopted in developing countries that already have a healthcare infrastructure in place.
Implementation of personalized therapies can be particularly difficult in developing countries that are already facing economic challenges due to a growing population. Nevertheless, the promise of personalized medicine holds a beacon of hope to millions of individuals suffering from debilitating diseases. Overall, the impact of personalized medicine will be translated into a lower burden of disease treatment on existing healthcare systems because of better clinical outcomes for patients.
Stay tuned for our next article on personalized medicine where we will dive into the concept in a much more detailed manner and provide you with real examples from the world of “personalized” medicine.
