Matching treatment to a patient’s genes
modern medicine is constantly advancing. One of the most intensive and fascinating fields of research is personalized medicine (also known as precision medicine), based on each patient’s personal genetic makeup.
Each of us has a unique genetic profile with different genes and traits. These differences in our genes cause us to react differently to infectious and inflammatory diseases, be at different risks for heart disease, cancer or diabetes, and other factors that have a profound effect on our health.
Personalized medicine in oncology – what is personalized cancer medicine?
Oncology is one of the areas in which personalized medicine is most vigorously implemented today.
Malignant tumors differ in the genetic changes they undergo in the malignancy process. These genetic variations can affect the tumor aggressiveness, its ability to divide, the chances of distant metastasis, and the reaction to chemical and biological treatment.
Accordingly, personalized tests aim to create a tailor-made treatment for each patient, instead of a “one size fits all” approach to all patients with the same disease. Such treatments are already being implemented in breast, colorectal and prostate cancer.
Mapping genes linked to the cancer grade helps predict the efficiency of chemical adjuvant therapy, such as after surgery. Certain tests predict the reaction of chemotherapy and biological drugs to targeted sites and changes in the tumor.
More examples of precision medicine
Personalized medicine can also be used for individualized drug choices according to a patient’s genetic profile, which can increase safety and effectiveness. drug metabolism (the way the body chemically breaks down and alters a drug) varies from person to person according to different enzyme function in the liver and other tissues.
Identifying patients who break down a certain drug faster than others can help choose dosage more effectively. These patients may be prescribed a higher dosage, while those who break down the drugs more slowly will be prescribed a lower dosage. This helps ensure drug effectiveness and creates a reduced risk for side effects and toxicity.
Beta blockers (drugs for reducing blood pressure) and coumadin (an anticoagulant) are among drugs known for introducing personalized medicine.
Another example of the current (and future) abilities of precision medicine is predicting risk factors. Choosing the appropriate treatment depends greatly on their risk for developing the disease. Patients in a greater risk may benefit from a more aggressive treatment, whereas medical follow-up or a lighter treatment may prove sufficient in patients at a lower risk.
Risk assessment is based on different genetic markers. For instance, gene mutations associated with an increased risk for diabetes can be mapped even before the disease breaks out, which allows building a more aggressive preventative treatment for carriers of this gene.
Innovative genetic tests now allow adjusting personalized antidepressant therapy.
The future of personalized medicine and possible obstacles
Despite promising advancements and the great potential personalized medicine holds, there are still several obstacles that prevent a wider development of these methods in routine medical practice.
Although significant changes have already been made, genetic testing is still considered expensive, requires skilled professionals, and cannot be performed promptly on demand. To make these tests accessible to all, further price reductions are necessary. In addition, there is still a significant lack of information regarding the link between gene mutations and their practical implementation in treatment. Which gene variants are linked to which diseases? When does a mutation affect the body’s reaction to a drug? These questions have yet to be fully answered.
Despite these disadvantages, there is no doubt that the future of personalized medicine will show profound advancement in individualized treatment that is tailor-made to each patient for the best possible results.