Introduction: Precision medicine’s advantages and disadvantages will be discussed in this article. The article’s initial part will define precision medicine and explain how it works. The second part of the article will identify the advantages and disadvantages of precision medicine and its potential future application.
Definition of precision medicine
In the past, medical approaches have been based on applying the same treatments to those with the same disease. Nowadays, scientists are trying to personalize drugs including genome analysis, to make them more specific and effective. Precision medicine is known as “personalized medicine or personalized care” although it has been part of the healthcare system for many years. Its idea is to approach tailoring disease prevention and treatment outcomes. Precision medicine places a strong emphasis on the personal approach that characterizes the doctor-patient relationship and considers various personal data, such as clinical, lifestyle, genetic, or biomarker information.
It is unclear exactly where precision medicine originated. However, on April 16th, 1999, in a Wall Street Journal article, personalized medicine was introduced for the first time. The same article reappeared in The Oncologist journal, which made it the first journal to introduce and promote personalized medicine to the medical world. Years later, personalized medicine was accompanying terms like disease heterogeneity, genetic variability, pharmacotherapy, drug‐ diagnostic codevelopment model, combination of drugs and diagnostics, oncology, hematology, targeted therapy, etc.
Even though personalized medicine was introduced 20 years ago, there is still no universally agreed-upon definition of personalized medicine. The National Cancer Institute defined personalized medicine as a branch of medicine that utilizes knowledge of a person‘s genes, proteins, and environment to prevent, diagnose, and treat disease . Meanwhile, the Food and Drug Administration (FDA) agency defined it as an innovative approach that focuses on disease prevention and treatment that considers variations in people‘s environments, genes, and lifestyles . They also specified that personalized medicine is also known as precision medicine. Recently, the European Society for Medical Oncology specified and concluded that precision medicine and personalized medicine are the same terms . Lately, precision medicine has been used as a preferred term instead of personalized medicine.
In precision medicine, clinicians create a plan of care that typically includes precise recommendations using data from specific lab tests. When developing drugs, for example, precision medicine focuses on using biomarkers to stratify individuals in clinical trials, thereby increasing the likelihood of a successful outcome and drug approval. Consequently, efficacy and/or safety outcomes will improve. Precision medicine is also a valuable tool for the toxicology field. Its principles can be applied to make decisions about whether to pursue a drug target, to comprehend interindividual variations in drug responses in both nonclinical and clinical settings, to help choose doses that maximize efficacy or minimize adverse events, and to make it easier to understand how a drug works.
To understand it better, let’s analyze its advantages and disadvantages.
Advantages of Precision Medicine
There are many advantages to the precision medicine application in healthcare. Firstly, this approach can be used to diagnose and distinguish diseases in a highly specific manner by categorizing them in a genetic order rather than by symptoms. This allows treatments to improve the prognosis of many. For example, a person who needs a blood transfusion is not given blood from a randomly selected donor; instead, the donor’s blood type is matched to the recipient to reduce the risk of complications.
Moreover, genomic analysis can disclose genetic variations which can guide drug dose, meaning that patients can get maximal drug benefits with minimal side effects. This has been accessible to a whole range of diseases, such as cancer or mental illness. For example, effective drug doses (guided by genomic analysis) have minimized the drug’s harmful side effects such as diarrhea, constipation, nausea, vomiting, etc.
Another strength of precision medicine, is its ability in disease prevention. With the use of sequencing technology, the understanding of how the disease should be assessed relies on prevention through both medications and lifestyle changes. The use of targeted therapies to treat particular cancer cell types, such as breast cancer cells that are HER2 positive, serves as an illustration of the application of precision medicine in tertiary prevention. Tumor marker testing to assist in the diagnosis of cancer is an example of how precision medicine is used in secondary prevention.
The patient‘s non-adherence to their treatments/therapies may result in additional healthcare costs. Precision medicine seems to have minimal side effects; therefore, it can motivate patients to adhere to their specific treatment. Consequently, this can reduce healthcare costs and expenses. For example, a person who is genetically predisposed to high cholesterol levels in his/her blood (a fact discovered through precision medicine) may feel motivated to take care of his health and have a healthy lifestyle.
Disadvantages of personalized medicine
Although personalized medicine has many advantages, as previously said, there are also many drawbacks that could prevent it from being the standard of care in the future. A major concern for precision medicine to reach peak efficiency is that a lot of genomic data must be collected from a large section of the population. It is legally unclear who owns the data if and when such a large volume of data is collected. The government does not own the data and FDA has blocked their own genetic information from companies. As a result, there would undoubtedly be strong opposition to the adoption of such a plan.
Furthermore, there are many issues within the legal sector. There may be issues with property rights, for instance, since some contend that restricting access to innovations will prevent the creation of future precision medicine.
Overall, there are a few legal issues that threat the future of precision medicine. However, the patient will be far more receptive to related care by their own physician, and such a situation would facilitate clinical communication and improve care management. Clinical trials will also make available treatments that would not otherwise be available or affordable to uninsured patients.
© COPYRIGHT: This article is the property of We Speak Science, a non-profit organization, co–founded by Dr. Detina Zalli and Dr. Argita Zalli. The article is written by Zoi Semini.
- Jørgensen JT. Twenty Years with Personalized Medicine: Past, Present, and Future of Individualized Pharmacotherapy. Oncologist. 2019;24(7):e432-e440. doi:10.1634/theoncologist.2019-0054
- Yates LR, Seoane J, Le Tourneau C, et al. The European Society for Medical Oncology (ESMO) Precision Medicine Glossary. Ann Oncol. 2018;29(1):30–35. doi:10.1093/annonc/mdx707