The Revolution of Personalized Medicine – Are We Going to Cure All Diseases and at What Price?
Casina Pio IV, 8-9 April 2019
The Technion Integrated Cancer Center (TICC)
The Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Haifa, Israel
One of the decades-old mysteries in medicine has been the observation that apparently similar diseases have a vastly different course in different patients. Similarly puzzling has been the hugely different response of patients with the “same” disease to similar drug treatment. Some patients respond favorably, some moderately, some do not respond at all, and some develop a broad range of side effects – from mild to fatalities – with or without a beneficial effect of the drug for the primary ailment for which it has been prescribed. Physicians and researchers have been lacking tools to predict the disease course or the response to drugs in individual patients, and have relied largely on statistics. While we have realized that these differences stem from the different genetic repertoire people harbor, we lacked access to the code. When the term Personalized Medicine was coined by Leroy Hood and became part of our daily jargon a bit more than a decade ago, the realization of this goal appeared to be an inevitable milestone on the road of future medicine. The journey began with the sequencing of the first human genome that lasted several years, cost several hundred million dollars, and was completed in 2000. With exciting technological developments, time span and cost have been shortened dramatically and still continue to decrease, converting genomic sequencing into an almost routine clinical test. The development of additional omics platforms (e.g. transcriptomics, proteomics, metabolomics) added important missing layers to our ability to obtain a complete profile of the individual patient and reaching a precise diagnosis of the pathogenetic mechanism of his/her ailment. Yet, the main gain of this revolution is still ahead of us – the discovery of novel disease targets with the development of therapeutic modalities to target them. With the mirror of medicine turning from treating a disease to treating a disease in the context of an individual patient – Personalized Medicine is going to be – in the vision of Leroy Hood – more Precise, but also Predictive, and therefore Preventive. Importantly, it is going to be also Participatory, where the patient is going to play a major role in the decision-making process of his/her treatment, and the physician becoming more of a professional consultant rather than an absolute authority. The newly evolving medicine is therefore known also known as the 4P’s medicine. Read more http://www.pas.va/content/accademia/en/events/2019/medicine.html