Have we entered the golden age for precision medicine?
SummaryHistorically, the way patients have been treated for diseases has been centred around our understanding of a dominant version of a disease as it occurs in the average human. The ailment is identified, a treatment path is offered, and drugs are prescribed. The effectiveness of this treatment, however, can vary due to a range of factors.
- Author Company: Canon Medical Research Europe
- Author Name: Dr Ken Sutherland
- Author Website: https://research.eu.medical.canon/
Historically, the way patients have been treated for diseases has been centred around our understanding of a dominant version of a disease as it occurs in the average human. The ailment is identified, a treatment path is offered, and drugs are prescribed. The effectiveness of this treatment, however, can vary due to a range of factors. The patient might have a particular variation of a disease, or a conflicting condition, or their biological makeup means certain drugs have little or no impact, or even adverse effects. We can see this more clearly with mainstream treatments of cancer – only 25% of cancer patients respond well to the drug treatments available for example.
What if we could better predict which treatment path would be most effective for an individual, based on their genetic makeup and behaviours, to provide a more personalised approach? This is the basis of precision medicine.
What is precision medicine?
Precision medicine is an approach that challenges the current one-size-fits-all approach to treatment. Considering the differences between individuals and using medical data from specific populations, such as those with a similar medical history, can help distinguish how conditions affect different groups of people. With this information, practitioners can make more informed decisions when choosing which treatment would be most effective.
Being more precise can lead to a more effective treatment plan being put in place. This data can also be used to initiate preventative actions for patients who are at a higher risk of developing/contracting variations of a disease, such as diabetes.
Technological advancements, and the COVID-19 pandemic, has vastly improved our learnings of medical conditions on an individual level. From the remote diagnosis of COVID variants, to easier access to the human genome through at-home tests, and wearable technology tracking our health information, medical experts are more capable of identifying new variations of diseases and can therefore diagnose, predict and prescribe the correct treatment to patients better than ever before.
Breakthroughs and room for growth
So, how can we tell we’re living in the golden era of precision medicine? Firstly, we need to acknowledge that precision medicine doesn’t just rely on the willingness of medical professionals, it involves many working parts to be successful.
Researchers, as well as healthcare professionals, specifically NHS staff, life-science industries and patients are crucial to bringing the precision medicine model to life and promoting worldwide adoption. These groups form what’s referred to as a triple helix model; an ecosystem that connects clinicians, researchers and industry together to find innovative healthcare solutions using data like electric health records, imaging, DNA sequencing, and family and medical history. Further development would require NHS adoption and integrating patient data sets to build understanding through case studies. The next two to three years will be crucial in establishing this as a mainstream practice.
Legacies and the Living Laboratory
The potential of precision medicine is best exemplified through the work being done at the Living Laboratory at the University of Glasgow. Supported by Canon, along with other life industry partners, UK Research and Innovation, NHS Greater Glasgow and the University of Glasgow, this research facility is a focal-point for R&D, open innovation, commercialisation, and adoption - bringing industry, academics, clinicians/NHS managers, patients and charities together to accelerate the development of precision medicine and translate innovation into clinical practice. My colleague, Professor Dame Anna Dominiczak and I see our role at Living Laboratory as helping transition precision medicine from theory to something tangible that can be used to save lives. It’s predicted that out of this initiative, around 100,000 patients will benefit from precision medicine by 2028.
An initial cohort in Greater Glasgow, trialled with precision medicine, showcases some of the real-world implications of pharmacogenomics-based medication management. Taking a sample of 165,000 patients over the age of 65, it was discovered that 36,000 patients in the cohort could have saved money and avoided patient suffering if they took a simple pharmacogenomic test on the genes that are known to contribute to (significant) adverse reactions to their prescribed medication. From this group, at least 71% were taking at least one drug with known genetic implications, and this test could save up in the regions of £85 million over three years by better informing medication management programmes.
Alongside this study, the Lighthouse Laboratory, which sits in the centre of the Living Laboratory used precision medicine diagnostics to test 25 million samples of the COVID-19 virus with PCR technology since its launch on 21 April 2020. The facility brought the triple helix partnership to life and is a leading example of how a life-science industry can bring innovation to market rapidly.
A brighter future
We are currently sitting on the edge of something great. We have the technology, we have the theory, and we have early evidence of the success of precision medicine in practice. The time to strike is now, but we need more life science industry specialists and strategy makers at a national and international level to adopt this thinking. With more widespread support, this golden age of precision medicine can only get brighter.