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Newsroom precision medicine

Precision medicine:
finding the right drug for the right patient at the right time

By Marshall Spearman

There is a saying in medicine: “Give the right drug to the right patient at the right dose at the right time.”

Sounds simple, right? In reality, defining the optimal treatment for a particular patient can be anything but. Doctors must weigh a multitude of complex factors, ranging from disease characteristics (including severity) to a patient’s characteristics, to past medical history, as well as treatment priorities.

But what if we could arm doctors with tools to help them identify the right drug faster? Imagine a future in which physicians can consult not just medical literature and treatment guidelines, but also formulas and statistical data to help select the therapies that have the best chance of success. What if an individual’s clinical and demographic data, as well as other characteristics, could tell the story of what their treatment journey might look like?

This scenario represents the potential of precision medicine.

Precision medicine refers to a rapidly emerging field which seeks to tailor treatments to the needs of individual patients based on genetics, biomarkers, clinical characteristics, and other predictive factors1.  In areas like oncology and cardiology, precision medicine has been understood and practiced for many years. For example, the ability to target specific genetic mutations has led to novel treatments for certain cancers, including chronic myeloid leukemia2 and lung cancer3.

The vast potential of precision medicine is clear: By identifying the right therapy(ies), including surgery, physical interventions, drug therapy, and other, for the right patient faster and more effectively, we may be able to improve long-term patient outcomes and reduce failed or unnecessary treatments. Not only would this deliver greater value to patients; it could also promote greater efficiency and lower long-term costs across the healthcare system.

In fields such as gastroenterology, we still have a ways to go to realize this vision. We are still in the early stages of harnessing precision medicine. At UCB, we are involved in projects that seek to analyze large amounts of clinical data to identify predictive factors for epilepsy and Crohn’s disease patients, among others.

Furthermore, precision medicine also requires that we define what the “right drug” actually means for each patient. For one person, the right treatment may be the one with the fewest side effects. Another may want to address a particular symptom. This underscores the importance of open and honest doctor-patient communication. While insights into factors such as biomarkers and algorithms could help inform treatment decisions, they cannot supersede the importance of the discussion between the physician and the patient in charting the diagnosis and management of the patient’s disease.

By continuing to promote research and by building broad support from healthcare leaders, we can take strides toward realizing the promise of precision medicine.

Question
What impact do you see precision medicine having on the healthcare landscape in the coming years?

 

References

  1. Jameson JL, Longo DL. Precision medicine - Personalized, problematic, and promising.  N Engl J Med. 2015; 372: 2229–2234.
  2.  Druker BJ, Guilhot F, O’Brien SG, et al. Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. N Engl J Med. 2006; 355: 2408-17.
  3. Kwak EL, Bang YJ, Camidge DR, et al. Anaplastic lymphoma kinase inhibition in non–small-cell lung cancer. N Engl J Med. 2010; 363: 1693-703.
  4. Jameson JL, Longo DL. Precision medicine - Personalized, problematic, and promising.  N Engl J Med. 2015; 372: 2229–2234.
  5. https://www.whitehouse.gov/precision-medicine.

What’s in a name?

By Marshall Spearman

In recent years, the terms “precision medicine” and “personalized medicine” have often been used interchangeably. In fact, these are two distinct terms, and their differences (while subtle) are important to understand when discussing this emerging area of medicine.

As pointed out in a recent article published by the New England Journal of Medicine, personalized medicine represents a long-practiced goal among physicians of seeking to provide care tailored to each patient’s individual needs4. In this sense, the concept of “personalized” care is not new.

Precision medicine, meanwhile, refers specifically to new advances in diagnostics, genetics, therapeutics and other emerging fields – such as big data and analytics – that can identify distinguishing patient or disease characteristics to better inform care.

While precision medicine is relatively new term, it has become further cemented in the medical lexicon thanks to the launch of US President Barack Obama’s Precision Medicine initiative. The project, which will invest $215 million to support research and development in this space, defines the goal of precision medicine as seeking to “tailor treatment and prevention strategies to people’s unique characteristics, including their genome sequence, microbiome composition, health history, lifestyle, and diet.”5

Think of it this way: The new advances and tools that are driving precision medicine could one day help doctors achieve their goal of providing more personalized treatment decisions for patients.