Are you hearing a lot about personalized medicine these days? What about precision medicine? It seems like the information being discussed is not necessarily new. Why does it seem to be everywhere lately? There are many answers to that but this two part series aims to outline some of the features of these models of medicine as a foundation.
Precision medicine is defined as a model for medicine that is customized based on the individual patient; all aspects of care can be personalized including medical decisions, treatments, practices, and products or services used. Another similar sounding term is “personalized medicine”. That National Institutes of Health indicates that there is overlap in the two terms. The real difference is mostly in the interpretation of the word “personalized” as compared to “precision”.
Precision, as a single word, means to hit a target in the same place over and over. Precision medicine aims to create medicine models that target a similar feature of a disease that appears in multiple diseases or cancers in some cases. This model is not unique for one single individual, however. This approach aims to identify which approaches will be effective for patients based on genetic, environmental, and lifestyle aspects.
The changes in technology and knowledge acquisition over the past few decades allow clinicians and researchers access to heaps of data on different cancer types. The historical approach has been to lump the cancer types together and treat everyone with that cancer type in the same therapeutic manner. Yet there are patients that do not respond to that therapy at all despite having the pathology/morphology of one type of cancer. We now know that there are molecular factors at play, right down to our DNA, which affect how a treatment may work on those cancerous cells. If the treatment action is based on one pathway leading to disease, what happens when that disease occurs due to a different pathway malfunction? Precision medicine dumps into the field of computational oncology which employs the expertise of statisticians, mathematicians, physicists, computer scientists, cancer biologists, physiological experts, physicians, researchers, and many more to create data programs and models including genetic profiles and therapeutic approaches for different cancers. In addition, pharmacogenetics is part of precision medicine because the whole basis of this field of study is how gene’s affect a particular patient’s response to a given pharmaceutical agent. If you enjoy pharmacology and genomics, this is the field for you.
The National Research Council has documented that they prefer the term precision medicine; the work involves building a network for biomedical research in order to basically develop a new taxonomical structure for disease. The National Academy of Sciences, in collaboration with the National Academy of Engineering, the Institute of Medicine, and the National Research Council, published a report exploring the future of precision medicine in 2011.