Our Healthcare Future, Through the Lens Of Precision Medicine

At only six years old, Emily Whitehead was diagnosed with leukemia. Considering her low chances of survival, her parents decided to enroll Whitehead as the first pediatric patient in a landmark immunotherapy trial at the Childre’'s Hospital of Philadelphia. The trial utilized specially engineered t-cells to recognize a surface protein on leukemia cells and destroy these cells throughout the body. Within 28 days, Whitehead was miraculously cancer-free. 

Today, standard medical treatments for conditions are designed to benefit the general patient population. However, this is harmful to individual patient outcomes, as individuals’ unique genetic profiles lead to different responses to treatment. Until recently, it was impractical to adjust treatment plans to patients’ genetics. Scientists simply didn’t have enough knowledge of how the genome or complex diseases worked to adjust treatment plans to individual needs.

This has changed thanks to increased genome sequencing and the storage of biological data in medical databases. The development of new computational tools, especially AI, has improved society’s ability to rapidly analyze and process data. The use of these advanced data analysis techniques to customize treatment plans and predict how a patient will respond to different treatments is referred to as precision medicine. Precision medicine is applied in two main circumstances. The first is when a biological factor in the global population has an impact on a commonly used treatment’s effectiveness. The second is with diseases that are life threatening and require personalized treatment to increase chances of survival.

An example of a drug impacted by a common genetic factor is aspirin, which can act as an anti-clotting agent. Millions of people in the U.S. take aspirin and other anticoagulants in order to reduce their odds of blood clots. However, a new study conducted by researchers at the National Institutes of Health (NIH) suggests that people with the common CYP2C19 gene variant don’t actually attain these benefits. This means that hundreds of thousands of people are taking unnecessary medication, which always comes with an inherent risk. For example, anti-clotting medication increases both chances of bleeding out from a wound and the healing time for minor wounds. Patients affected by this gene variant would need an alternative treatment to resolve their blood clots. Only through the application of precision medicine can doctors predict drug ineffectiveness in those with specific gene variants. 

A good example of an extremely life threatening condition that requires precision medicine is late-stage cancers.  Precision medicine, specifically in the form of big data tumor sequencing, can be utilized to identify those with increased risks of cancer and accelerate the start of prophylactic treatment at the earliest warning signs. According to the National Library of Medicine, early cancer diagnoses have significant positive impacts on patient outcomes. Furthermore, treatments can be tailored directly to a cancer’s genetic profile. Once the mutations behind an individual’s cancer are discovered, doctors can prescribe the correct medication for that patient. An example of a drug prescribed largely with the aid of precision medicine is crizotinib, a cell growth blocker that is mostly utilized in the fight against cancers caused by ALK and ROS1 mutations. 

While it is clear that the applications of precision medicine already have immense potential, its capabilities will only grow in the future. As we learn more and improve our ability to synthesize molecules, we will be able to rapidly expand the uses of precision medicine. In the short term, we should focus on applying big data analytics through AI and other computational tools to nearly every hospital visit. This would allow for earlier disease detection, and give doctors access to far more information when making decisions about treatment plans. 

The only obstacle that remains in the way of this technology's future is the belief that precision medicine is unethical, primarily because it utilizes genetic data. People have expressed concerns that insurance companies and hospitals might misuse their data. While there are strict regulations on how genetic data can be used, these regulations still have some loopholes. 

Precision medicine is a vital tool used to improve our ability to fight diseases. Only through its use can we predict the impacts of treatment plans before they’re implemented and save countless lives. Precision medicine has already had a major impact on patient care, and its future promises more possibilities for treatments tailored to each individual’s DNA.