The Future is Personalized Medicine

Personalized Medicine (PM) is thought to be the next major advancement in the provision of healthcare. Once hospitals and healthcare practitioners acquaint themselves with evolving technologies in pharmacogenomics, pharmacogenetics, metabolomics, etc, they will be able to offer more effective services to the patients. For example, under this impending healthcare revolution, patients will be able to walk into a doctor’s office with a ‘smart card’ in hand, which contains encoded sequence of their genome. Armed with a complete and accurate understanding of a patient’s unique genome,the physician can then prescribe the right drug in the right dosage at the right time to effectively treat the health condition. Pharmacogenomics and pharmacogenetics, which are expected to be at the core of PM, combine to offer several advantages over conventional clinical methods. For example, while pharmacogenomics is limited to identifyng ‘inheritable response’ to medication across the whole genome, pharmacogenetics studies the effects of medication at the level of individual genes (the chart below outlines how it operates). The former also tries to reveal important links between genomic patterns and clinical responses. Such links are crucial sources of medical knowledge, as they empower clinicians to choose a particular treatment option based on individual patient condition as opposed to adopting a formulaic trial-and-error approach. (Hood, 2003, p.582)

The Human Genome Project (HGP), initiated and supported by former American President Bill Clinton was pivotal to subsequent breakthroughs in Personalized Medicine. With the help of advanced computing power, already more than 3 billion base pairs of DNA have been successfully mapped. With the completion of the HGP in 2003, new possibilities for PM have been opened up. Working expeditiously to make Personalized Medicine a reality in the near future are such organizations as the International HapMap Project, the NIH Encyclopedia of DNA Elements (ENCODE), the Roadmap Epigenomics Program, etc. (Cox, et. al., 2007, p.112)

In order to understand the scope and effectiveness of Personalized Medicine, let us take a hypothetical case. For instance, in the case of oncology treatment, where presently oral-intake medicines can cost hundreds (if not thousands) of dollars per year for the afflicted patient, understanding the intricate ‘genetic pathways’ (which is unique to each individual) is important in order to determine the probable efficacy of a particular therapy course. It is a sign of progress that in the United States today “there are 6 drugs for which FDA requires diagnostic genetic testing before prescription, about 30 for which a diagnostic test is recommended, and another 200 with pharmacogenomic information on the labels.” (Hesselgrave, 2010, p.16)

Moreover, traditional healthcare provision adopts an one-size-fits-all approach. Whereas, under Personalized Medicine, this practice will be dismantled and unique prognostic courses would be designed based on the patient’s genetic make up. Powerful technologies that try to understand the working of the human body down to the cellular level will be part of future PM treatments. These technologies include genomics, proteomics (the study of proteins), and metabolomics (the study of metabolites) amongst others. Metabolomics is of special interest to physicians as it has the potential to provide key information about individual patients. While the purpose of proteomics research is to identify abnormal protein patterns in patients, the purpose of metabolomic research is to identify abnormal metabolite patterns. Scientists are of the view that human bodies contain more than 3,000 metabolites that play a crucial role in proper growth and development of various organs. Apart from these primary metabolites there are secondary metabolites which strenghthen the immune system and helps reduce mental and physical stress. Of particular interest to the medical community are low-molecular-weight metabolites such as amino acids, carbohydrates, sugars and lipids, which can offer vital information about a patient’s health. (Bren, 2005)

1 2