Precision medicine has been a buzzword in the healthcare industry, and while this is not a new concept, recent advances in technology and science have helped increase awareness and sped up the pace for better patient care.
What is Precision Medicine?
In short, precision medicine provides a more customized and specific approach to treating patients. Data about a person’s genetic makeup, including variables such as genes, demographic information, medication history, and lifestyle is gathered to understand and analyze which components of our genes can lead to genetic mutations, or in other words diseases.
By extracting unique characteristics of each person, physicians can better understand which patients respond to which kind of treatments and most importantly carve out opportunities for more targeted treatments and breakthroughs. Rachel Green, Customer Relationship Manager at Nexon Healthcare, believes that “precision medicine will rapidly evolve and improve patients’ quality of life, we know that everyone has a different genetic code, so why should we treat everyone with the same drugs or with the same method?”
Rather than frantically joining the race to cure diseases, precision medicine enables us to focus our efforts on preventing diseases before it strikes and this affects almost every role within healthcare! With this approach, physicians and pharmacists can identify patients susceptible to adverse effects. For patients, this results in earlier diagnosis, better prevention, and improved treatments, while pharmaceutical organizations will benefit from increased efficiency. The time and investment to develop the right drugs are cut by half if they know what medication needs to be produced.
The image below demonstrates current practices to treating patients vs. the precision medicine paradigm.
Image source: Quest Diagnostics
At present, the healthcare sector is mainly focused on generalized solutions with which the most significant ratio of ill people could be treated. If hay fever nasal spray was good for the majority of those suffering from pollen and only a handful of people had an allergic reaction to it, there was no question about treating hay fever with nasal spray.
However, we know that nasal spray does not work for all hay fever sufferers. According to Allergy UK, 62% of hay fever sufferers state that their current hay fever medication isn’t effective, while a further
4% says that their medication eliminates symptoms. Hay fever treatments come in many formats and do not contain the same active ingredients, so one type of treatment may be more effective than the other, and it is a matter of trial and error for the user.
Unlike the traditional medicinal approach which relies on a one size fits all strategy, under the precision medicine paradigm, patients are offered tailored. Firms will also see faster and more precise responses to drugs, which will save millions in the long run.
Cancer is a killer disease
In the fight against cancer, precision medicine is one of the most promising tools and the logical outcome of current healthcare trends. For a more in-depth analysis, let’s take the example of treating cancer. The current approach to treating cancer depends on some factors, which takes into consideration:
- Where your cancer is
- Size of cancer/ tumor
- Whether cancer has spread
- Type of cancer
Based on this information, doctors are likely to recommend a combination of chemotherapy, radiotherapy or surgery to remove cancerous cells. Although the cancer survival rate is much higher in comparison to previous years, the current survival rate for cancer is 50%.
There are now so many variations of cancer that it is difficult to treat it with traditional, old methods. This also includes radiation and chemotherapy, although it is seen as one of the most effective treatments against cancer by stopping the regeneration of cancerous cells, there are still downsides associated with the treatment. For instance, chemotherapy and radiation affect everyone differently, meaning this may not work so well for everyone since it is not utilized in targeted ways. Furthermore, chemotherapy is known to damage healthy cells, which is why many patients suffer from hair loss, or may not benefit from the combination and develop side-effects due to the non-selective nature of the treatment.
After decades of research, scientists now understand that patients’ tumors have genetic changes that cause cancer to grow and spread. Cancer is a heterogeneous disease, which explains differences not only between cancer cells from different patients but also between cancer cells within a single patient, this is why a more targeted approach of treating cancer is required.
With precision medicine, information about genetic changes in your tumor can help decide which treatment will work best for you, and consequently cut out the treatments that are not likely to help.
The image below demonstrates how precision medicine will trial patients.
Image source: UAB
Precision medicine has already helped patients such as AJ Patel. Back in 2013, Patel was diagnosed with stage 4 lung cancer. After visiting Karen Reckamp, Co-Director of the Lung and Thoracic Oncology Program at the City of Hope, the results from a brain scan revealed that the tumors had spread to his brain.
During surgery to remove the tumor, doctors took a swatch of Patel’s tumor tissue for genetic analysis to gain deeper insight. The results showed that the patient had a genetic alteration called ROS-1, which is found in only 1% of cases of non-small cell lung cancer. From this result, Patel started personalized treatment with an experimental drug called crizotinib and, by the summer, his tumors had shrunk dramatically from 6cm to less than 1cm! In essence, understanding the genetic variation has removed the guesswork of choosing an effective therapy. While there is still a substantial amount to learn, precision medicine has changed the world of oncology for the better
Which companies are leading the way?
Tech giants, such as Microsoft are leading the way to solve cancer. According to Microsoft, they are using machine learning and natural language processing to help the world’s leading oncologists figure out the most effective, individualized cancer treatment for their patients, by providing an intuitive way to sort through all the research data available. Another group of researchers under Microsoft, have also created algorithms that will help scientists understand how cancers develop and what treatments will work best to fight them.
The video below discusses this healthcare initiative.
Apart from Microsoft, Morphotek – a leading science company is also leading the way. Led by Dr. Nicholas Nicolaides, the organization takes a different approach to treating cancer. Knowing that there are more than three hundred different types of cancer, in addition to the fact that each type of cancer responds differently when confronted with different treatments, Morphotek has decided to pursue a course of developing “designer antibodies.” These custom antibodies are engineered in the lab to be hyper-effective at combating one very specific form of cancer and leaving healthy cells untouched.
Similarly, tech giant IBM has capitalised in the precision medicine market and have invested a further $200 million to improve and expand its Watson IoT data analytics. For those who are not familiar with Watson, this is simply an automated system for prioritizing somatic variants and identifying drugs, designed to tackle multiple challenges in healthcare.
According to IBM, Watson uses a unique approach and a combination of data, cloud and AI services in order to build cognitive offerings to speed up drug discovery. For example, Watson for Genomics, analyzes and categorizes genetic alterations that are related to cancer progression and provides a list of potential therapeutic options that target each alteration. The interpretation is done within minutes, and a comprehensive report is generated.
Several studies have already shown the effectiveness of Watson in being able to interpret data much quicker than a team of experts, with one in particular demonstrating how IBM Watson took just 10 minutes to analyze a brain-cancer patient’s genome and suggest a treatment plan! This shows the potential of artificial intelligent medicine to improve patient care, which would have taken 160 hours of human expert’s time to make a comparable plan.
Image source: IBM
Watson is already helping cancer care teams around the world implement a more patient-centric cancer care model. The software is enrolled out in more than 150 hospitals and health organizations in 11 countries.
Although precision medicine is still in its early stages for the treatment of cancer, with much more clinical trials and errors required to be conducted, this has the ability to deliver the right treatment for the right patient at the right time, leading to lower healthcare costs and hopefully a better survival rate.
So which country is set to dominate the market?
The global value of precision medicine accounted for $38.92 billion in 2015 and is estimated to reach $88.64 billion by 2022. It has been predicted that North America especially the U.S. is expected to be the hub of the global precision medicine market, which is set to occupy more than 40% of market share. In particular, Vanderbilt University Medical Center has already received a $71.6 million grant — the largest in its history — from the federal government to establish a data research center under an initiative to bring tailored treatment into everyday medicine.
However, China has also aimed to build its credential in precision medicine by investing a 15-year project with US$9.2 billion, with the government confirming plans to make precision medicine part of its five year plan for 2016-2020 as it works to prioritize genomics to drive better health care outcomes. Anticipating the initiative, leading institutes — including Tsinghua University, Fudan University and the Chinese Academy of Medical Sciences — are scrambling to set up precision-medicine centres to sequence 1 million human genomes itself — the same goal as the entire US initiative. The hospital will focus on ten diseases, starting with lung cancer.
and have already started research back in 2010, with a series of workshops exploring different research areas that can make a contribution to developing precision medicine. The results from the workshops were brought together in a 2011 conference entitled European Perspectives in personalized medicine. Furthermore, the big data analytics segment is having a huge demand in the Europe precision medicine market owing to increased applications in the healthcare, and healthcare IT sectors.
Global Precision Medicine Market, by Region 2015 & 2022 (USD million)
This graph shows the global medicine market by region in 2015 and what is forecasted in 2022.
Graph source: Market Research Future
Although precision medicine is still in its early stages for the treatment of cancer, with much more clinical trials and errors required to be conducted, this has the ability to deliver the right treatment for the right patient at the right time, leading to lower healthcare costs and hopefully a better survival rate.
Are there any challenges with precision medicine?
The acceleration of precision medicine holds a great deal of hope for patients with rare cancers, inherited conditions, and other diseases, but the shift from research to reality is not without its challenges:
- Cost and investment is a major factor. Research into precision medicine requires a substantial amount of money, research and extensive collaboration among all medical providers. As the number of tests needs verification, the process is lengthy in order to prove that certain treatments will actually help prevent or treat a disease.
- Time. During Obama’s time as president, he launched the Precision Medicine Initiative with a $215 million investment to revolutionize how we improve health and treat disease. Data will be collected from 1 million volunteers, who are willing to share their health and genetic information to help researchers develop individualized treatments. Although this is a substantial amount of data, this is not a random cross-section of people in the US. As a result, this may not represent the population adequately in order to make population health recommendations. Furthermore, all of this will take a lot of time to incorporate, just think how long it will take to collect and group 1 million data.
- Data issues– since physicians are collecting confidential health information, one of the main question to address is how will data be stored? There is a need for an effective electronic health record system, which at present is too fragmented and not practical for the demands.
- Privacy issues – If organizations require all of our healthcare information including our DNA or genetic databases, this could raise privacy issues and the question of how many people will be able to view our data. Data given, may need to be anonymize and numbers could be used rather than names.
Although it is undeniable that precision medicine is bringing optimism and excitement healthcare industry, we must be reminded that even the most advanced new therapies must be built on a solid foundation of methodical implementation.
What the future holds?
Healthcare is in the center of a transformation from a one-size-fits-all approach to a more personalized and targeted approach to patient care. Already, breakthroughs in precision medicine have created benefits for patients with diseases such as leukemia and cancer, more research still needs to be done to further enroll this out.
We are starting to learn more about specific treatments for cancers and other diseases based on the origin of the illness and through our own genetic makeup, rather than simply carrying out a few tests and assuming that every patient will end up with the same treatment. Through precision medicine, researchers are starting to be able to identify the genetic roots of certain cancers, but the acknowledgement that cancer is not a single disease is central to being able to treat it effectively.
By using genes and DNA analysis, personalized healthcare has the capacity to detect the onset of a disease at its earliest stages, and at the same time, increase the efficiency of the health care system by improving quality, accessibility, and affordability.
Article provided by Nexon Hygiene.
