Personalized medicine, or more commonly called precision medicine, is the whole aspect of changing healthcare from a generic one-size-fits-all application of treatment towards adopting remedy based on individual genetic requirements. The idea promises to provide better patient results, minimize side effects, and maximize therapeutic effects (Collins & Varmus, 2015). One thing is for sure; genomics, bioinformatics, and biotechnology advances are slowly converging, pushing personalized medicine to the forefront of current healthcare (Ashley, 2016). 

Understanding Personalized Medicine

Personalized medicine is essentially the knowledge applied to preventive, diagnostic, and therapeutic decisions related to disease in consideration of genetic, environmental, and lifestyle factors (Green et al., 2017). The entire human genetic code was made available to the world in 2003 with the completion of the Human Genome Project, thus clearing the way for personalized medicine. Along with the identification of polymorphic variations within the human genome that might be associated with certain diseases came the conception of targeted therapies (Phillips et al., 2018). 

Various genetic tests are used in personalized medicine, and by using DNA analysis, the provider can assess vulnerability for certain diseases, find medications that will work for that patient, and find possible adverse reactions to the prescribed drugs (Collins & Varmus, 2015). Pharmacogenomics is another example where clinicians can prescribe drugs to patients in accordance with their genetic profiles so that those drugs will work best at optimum doses with the least side-effects (Ashley, 2016). 

Applications of Personalized Medicine 

  • Acute information concerning the cancer treatment: Personalized medicine has advanced considerably in oncology. HER2 inhibitors for breast cancers and tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia have improved the survival and quality of life (Green et al., 2017). Oncologists can now identify those mutations that are driving the growth of the cancer by sequencing the tumor’s DNA and choose therapies that specifically target those alterations (Phillips et al., 2018). 
  • Cardiovascular diseases: Genetic testing helps identify candidates for at-risk conditions and their early intervention with lifestyle modifications and drugs, for example, in the case of familial hypercholesterolemia (Collins and Varmus, 2015). Pharmacogenomics determine the use of anticoagulants and antiplatelet drugs in a manner that reduces risk of adverse events (Ashley, 2016). 
  • Rare Genetic Disorders: Advancements in gene therapy give a glimmer of hope to patients with rare genetic diseases. Treatments, such as Luxturna for inherited retinal dystrophy and Zolgensma for spinal muscular atrophy, are exemplifying the potential of gene therapies to correct genetic defects at the source (Green et al., 2017). 
  • Infectious Diseases: Likewise, the field of personalized medicine is restructuring the management of control toward the treatment of infectious diseases. Genotypic resistance testing, for example, assists in tailoring the antiretroviral therapy to HIV patients with an eye to optimizing treatment efficacy and reducing drug resistance (Phillips et al., 2018). 

Challenges and Ethical Considerations

Although the idea sounds great, personalized medicine faces several obstacles which include: 

  • Economic aspect and accessibility: The fact that genetic testing and targeted therapies are very expensive can limit their use by some populations. 
  • Data Privacy: The collection and storage of genetic data raise privacy and security concerns. Safeguards must be all the more rigid to protect sensitive information against misuse (Ashley, 2016). 
  • Ethical Issues: Genetic discrimination by employers or insurance companies is a significant ethical issue. The Genetic Information Nondiscrimination Act (GINA) is an example of legislation aimed at addressing such issues in the United States (Green et al., 2017). 

The Future of Personalized Medicine 

The personalized medicine field shines into the future as developments in technology and research are on the march. Among some major trends are the following: 

  • AI Integration: AI and machine learning algorithms would go through vast amounts of genetic and clinical data to discern patterns that predict treatment response, increasing therefore the accuracy of diagnosis and treatment planning for the case at hand (Phillips et al., 2018). 
  • Enlargement of Genomic Databases: Mega-genomic undertakings and biobanks are also concerned with revealing genetic variations among different populations for more inclusive and effective personalized treatments (Green et al., 2017).  
  • Advancements In Gene Editing: Technologies, such as CRISPR-Cas9, are thus able to correct genetic mutation at the level of DNA, thus presenting curative avenues in the treatment of genetic disorders (Ashley, 2016).  
  • Personalized Preventive Care: However, personalized medicine in recent years has begun to shift itself toward prevention, utilizing genetic risk assessments to inform lifestyle modifications and early interventions to impede the expression of a disease (Collins & Varmus, 2015). 

Conclusion

With treatment considerations made for minimal adverse effects, personalized medicine offers an entire approach to health care considering variables such as genetics, environment, and lifestyle. The applications range from oncology to cardiovascular diseases, rare genetic disorders, and infectious diseases. Personalization invokes targeted interventions, effective therapies, and patient involvement in care-through challenging reimbursement, data privacy, and ethical issues to the upcoming view of personalized medicine, driven by artificial intelligence, genomics, and gene editing. 

Reference

  1. CollinsF. S., & Varmus, H. (2015). A new initiative on precision medicine. New England Journal of Medicine, 372(9), 793–795. https://doi.org/10.1056/NEJMp1500523 
  2. Ashley.. (2016). Towards precision medicine. Nature Reviews Genetics, 17(9), 507–522. https://doi.org/10.1038/nrg.2016.86 
  3. Green, E.,t al. (2017). The human genome project: A 20-year journey. Science, 357(6346), 866–867. https://doi.org/10.1126/science.aam8977 
  4. Phillips, K.,t al. (2018). Precision medicine: Opportunities, challenges, and the future. JAMA, 319(19), 1979–1980. https://doi.org/10.1001/jama.2018.14962 
  5. Ashley, E. A. (2016). The precision medicine initiative: A new national effort. JAMA, 315(7), 613-614. https://doi.org/10.1001/jama.2016.0297 
  6. Green, E. D., Gunter, C., Biesecker, L. G., & Di Francesco, V. (2017). Strategic vision for improving human health at The Forefront of Genomics. Nature, 551(7679), 27-31. https://doi.org/10.1038/nature24286 
  7. Phillips, K. A., Douglas, M. P., & Trosman, J. R. (2018). Evolution of personalized medicine and implications for coverage and reimbursement. Health Affairs, 37(5), 694-701. https://doi.org/10.1377/hlthaff.2017.1626 

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