An concise article from Sean Khozin and Gideon Blumenthal (2015) try to explain.
“Personalized (or precision) medicine has been broadly described as the administration of the right therapy to the right patient at the right dose and intensity.” However, this is a fairly broad definition. Some more concrete examples of personalized medicine include:
Modern concepts in personalized medicine are defined by their focus on utilizing advances in technology for tailoring care. Blood typing to guide transfusions, monitoring the international normalized ratio for dosing warfarin, and predicting hypersensitivity reactions to the antiretroviral drug abacavir based on the presence of the HLA-B*5701 allele are well-known examples of a biomarker-driven approach to personalizing care in modern medicine.
The importance of personalized medicine has grown such that President Obama included $215 million for a Precision Medicine Initiative in the 2016 budget. Announced at the 2015 State of the Union address, the initiate aims to “pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for which patients.” The funding covers:
- National Institute of Health: $130m to develop a national research cohort of a million or more volunteers which will include data rom medical records, lifestyle, patient reported outcomes, and personal device and biometric sensor data.
- National Cancer Institute: $70m to scale up efforts to identify genomic drives in cancer and use this information to improve treatments.
- Food and Drug Administration: $10m to acquire additional expertise and advance the development of high-quality databases to support regulatory structure needed to advance innovation in precision medicine.
- Office of the National Coordinator for Health: $5m to develop interoperability standards and requirements to address privacy and data security issues with respect to NIH and other precision medicine initiatives.
Many of the advances in precision medicine have occurred in cancer patients. The authors conclude by saying:
Recent technological advances in development of targeted therapies using kinase inhibitors and monoclonal antibodies have paved the way for personalization of therapy in a growing segment of cancer patients…Given that most cancers may be caused by random mutations arising from stem cell divisions of normal self-renewing cells, application of our evolving understanding of cancer genomics to secondary prevention for detection of early oncogenic events is an important strategy for reducing the burden of cancer-related deaths that can augment personalization of care in the global fight against cancer.
In short, precision medicine is coming and innovation is happening fast.