Trends in Biotechnology
OpinionPersonalized medicine: revolutionizing drug discovery and patient care
Section snippets
Innovation in pharmaceutical industry R&D strategy
Knowledge of the molecular basis of disease is already transforming pharmaceutical development. Drug discovery and development has traditionally been a linear process (Fig. 1) with little feedback from later clinical development stages on the overall process. The adoption of a personalized medicine strategy in drug discovery and development necessitates a paradigm shift from a linear process to an integrated and heuristic one (Fig. 2). This new approach will involve a series of research
Molecular diagnosis will determine prognosis and therapy
Personalized medicine is rooted in the hypothesis that diseases are heterogeneous, from their causes to rates of progression to their response to drugs. Each person's disease might be unique and therefore that person needs to be treated as an individual. With limited understanding of the molecular basis of disease, we have relied on non-specific clinical signs. As genomic tools are sharpened, so will be our ability to dissect disease into its component parts. Clinical phenotypes thought to be
Innovation in patient care
The ultimate goal of personalized medicine is to define disease at the molecular level so that preventive resources and therapeutic agents can be directed at the right population of people while they are still well (Box 2). The application of new technologies and the integration of data from an individual will lead to a new paradigm in patient care that will emerge from strategies employed in pharmaceutical research and development – a paradigm that will, for the first time, allow physicians to
Personalized medicine: it's happening now
The past few years have seen major advances in technology and the growth of genomic information as a byproduct of the human genome project. As a result, new and innovative markers of disease are being uncovered at an unprecedented rate. At the DNA level, >350 genetic tests are currently available (http://www.genetests.org). Although most tests are for rare, monogenic disorders, some are becoming available for more common, complex diseases. Examples include APOE testing among dementia patients
Challenges of realizing the promise of personalized medicine
In spite of the achievement of a complete human genome sequence, there are numerous challenges in realizing the personalized medicine vision (Box 3). Identifying genetic variants that are markers of disease or drug response requires sifting through several million SNPs in the human genome to find those that contribute to the disease and then demonstrating that the SNPs are clinically valid markers and are useful for managing patients. To uncover DNA variants that predict common, complex
A vision for the practice of medicine in the 21st century
In the next decade, medical care will undergo revolutionary changes. No longer will medical practice be limited to the empirical extrapolation of a patient's care from generalized clinical-trial results. Traditional medical practice, based on trial-and-error, results in both under-treatment and over-treatment, multiple office visits, the need for drug monitoring, and frequent regimen changes. More than 100 000 deaths per year are attributed to adverse drug reactions 26, 27. A personalized
Summary
Personalized medicine promises to offer the right treatment for the right patient at the right time. Although that promise might seem far off, there is clear evidence that the traditional trial-and-error practice of medicine is eroding in favor of more precise marker-assisted diagnosis and treatment. For the patient, the benefits are clear: safer and more effective treatment of disease. For industry there appears an equally desirable outcome of this approach: increased efficiency, productivity
References (27)
Microarray analysis of hepatotoxins in vitro reveals a correlation between gene expression profiles and mechanisms of toxicity
Toxicol. Lett.
(2001)Progress in the prevention of breast cancer: concept to reality
J. Steroid Biochem. Mol. Biol.
(2000)Drug-resistance genotyping in HIV-1 therapy: the VIRADAPT randomised controlled trial
Lancet
(1999)- et al.
Genomania meets the bottom line
Science
(2001) Positional cloning of the mouse obese gene and its human homologue
Nature
(1994)Elevated levels of insulin, leptin and blood lipids in olanzapine-treated patients with schizophrenia or related psychoses
J. Clin. Psychiatry
(2000)Monitoring serum insulin-like growth factor-I (IGF-I), IGF binding protein-3 (IGFBP-3), IGF-1/IGFBP-3 molar ratio and leptin during growth hormone treatment for disordered growth
Clin. Endocrinol.
(2000)A structural basis for drug-induced long QT syndrome
Proc. Natl. Acad. Sci. U. S. A.
(2000)- Miller, M.C. et al. (2001) Genetic variability in susceptibility and response to toxicants. Toxicol. Lett....
Molecular classification of cancer: class discovery and class prediction by gene expression monitoring
Science
(1999)
Gene-expression profiles in hereditary breast cancer
New Engl. J. Med.
Genetic and molecular basis of cardiac arrhythmias: Impact on clinical management. Part III
Circulation
Influence of genotype on clinical course of the long-QT syndrome
New Engl. J. Med.
Cited by (332)
Reviewing methods of deep learning for intelligent healthcare systems in genomics and biomedicine
2023, Biomedical Signal Processing and ControlSystematic Review of the Effectiveness of Machine Learning Algorithms for Classifying Pain Intensity, Phenotype or Treatment Outcomes Using Electroencephalogram Data
2022, Journal of PainCitation Excerpt :The clinical relevance is therefore currently questionable. Should future research improve the current limitations and performance, ML may eventually be clinically advantageous by reducing trial-and-error treatment.30-32 Indeed, the results across all three domains remain promising, but considering that 42 of the 44 studies in this review were deemed high ROB, there is a possibility that the synthesized results are inflated or are not fully generalizable.
High-resolution 3D printing for healthcare
2022, 3D Printing in MedicineRole of pharmacogenomics for prediction of personalized medicines
2022, Biochemistry of Drug Metabolizing Enzymes: Trends and Challenges