PRECISION MEDICINE-THE PROSPECTIVE FUTURE

PRECISION MEDICINE-THE PROSPECTIVE FUTURE

Precision medicine is nothing but customized medicine. What could be more interesting
than customizing of healthcare with medical decisions, treatment, practices, or products
being adjusted to individual patients instead of a drug that fits all model. It is an
emerging approach for prevention and treatment that takes into consideration individual
variability in genes and lifestyle of a person. As the word precise means accurate ,this
model will help the physician and researchers to predict accurately the treatment and
prevention strategies for a particular disease will work in which groups of people.
In comparison to traditional medicine (a drug which fits all model) ,in which disease
treatment and prevention strategies are developed for average people is less accurate,
taking less considerations into differences between individuals.  

Even though this concept of precise medicine is new but it has been a part of healthcare
for many years. For example, a person who needs blood transfusion is not just given
from a random donor instead the donor’s type is matched to recipient.

                              

PRECISION MEDICINE-MODERN TREATMENT MODEL!

That day is not far where precision medicine will be used for our treatment and
prevention management. 

Here are some of the examples where precision medicine is already being used:

• Before a blood transfusion, doctors match the donor's blood to the recipient's to
  
  

make sure the two are compatible.

• Trastuzumab (Herceptin), a breast cancer drug, is designed to treat women whose
  
  

tumors have a protein called HER2.

• A gene test can predict whether people who receive a heart transplant will reject
  
  

the transplanted organ.

PRECISION MEDICINE VS TRADITIONAL MEDICINE

Traditional medicine – one size fits all approach.

Example, drugs and treatment common for the treatment of large group of people
irrespective of sex, age, weight, a treatment which is most likely to work for everyone
with same illness. Unfortunately, not all individual respond in the same way. Some
drugs may work wonders for many people whereas in some it may cause harmful
effects. Usually, finding a right drug for an individual may involve a lot of trial and error. 

Precision medicine is a step ahead. Physicians use information about an individual like
about his genes, lifestyle, and environment along with the characteristics of the disease
to select medicine that works best for the patient.

Example, targeted therapy to treat specific type of cancer cell, like those in HER2-positive
breast cancer.

DISEASE MANAGEMENT BY PRECISION MEDICINE:

CYSTIC FIBROSIS: Cystic fibrosis (CF) is a severe, monogenic, autosomal recessive
disease caused by mutations in the CFTR (cystic fibrosis transmembrane regulator)
gene, where disturbed chloride and bicarbonate transportation in epithelial cells results
in a multiorgan disease with primarily pulmonary infections and pancreatic insufficiency
. Close monitoring and treatment of Pseudomonas lung infection as well as segregation
of patients with different infection status improved the clinical outcome as well as
survival. Prophylactic basic treatment as well as infection treatments follow specific
algorithms. A variety of comorbidities have all along the pulmonary infection control
necessitated personalized care, adjusted to the patients' phenotype. With the introduction
of CFTR modulators, the treatment has shifted from prophylactic, symptomatic type
toward a new era of precision medicine targeting the basic defect according to the
patients' CFTR genotype. Future directions will focus on further improvement of the
CFTR modulators and gene therapy, as well as modifier genes and CF phenotype.

CANCERS:  The genetics of some breast cancers, for instance, may be more like

stomach tumors than other breast cancers. With precision medicine, cancers that are

genetically alike are treated similarly.

For example, doctors know a drug called Gleevec (imatinib) works to treat leukemia

only when the cancer cells have one particular genetic makeup. So, rather than treat

everyone with leukemia using Gleevec, doctors test people for that specific genetic

mix and give the drug only to those who have it.

They’re using the same approach to decide which meds people take for breast, lung, and

colorectal cancers, as well as melanoma.

Just as traditional drugs aren’t a sure bet to cure cancer, precision medicines aren’t

always a permanent cure. Cancers can evolve over time and become resistant to a

treatment. Or a drug may work against only part of a tumor, which lets the remaining

part continue to grow.

To test all this out, researchers are turning to something called “basket trials.”

The “basket” is based on the genetics of your cancer, not where it is in your body. For

example, in a basket trial researchers are using today to test cancer drugs, people with

many types of cancer are grouped together. The treatment they receive is based on the

genetics of their tumor. Researchers hope the results will help show the success of

precision medicine.

MECHANISM OF PRECISION MEDICINE:

The FDA approves a new drug when studies show that its benefits outweigh its risks.

That means people who take it will do better with it and won’t be hurt by it. Yet that

doesn't mean the medicine will help everyone who takes it.

Precision medicine is much more targeted. Over years of research, scientists have

learned more about the genetics behind how diseases start and how they behave.

Many diseases are linked to gene changes. Researchers now have a map of all the genes

in the human body. They can see how certain gene changes cause disease and what

makes one person's heart disease, diabetes, or cancer act differently from another's.

Knowing how genes and diseases interact can help them fine-tune treatments to make

them work better.

For example, we now know that certain gene changes make some cancers grow faster

than others. Targeting these changes makes personalized medicine a much more precise

and effective way to slow or stop cancer.

USES:

• It helps to learn about disease risk. By testing your genes you can assess the risk of
  
  

exposure to a disease running in your family. 

• It helps to prevent disease. Once we know we carry a certain gene, we may be able
  
  

to make lifestyle changes or get medical treatment so you don’t get sick. For

example, women who carry the BRCA1 or BRCA2  gene mutation are at higher

risk for breast cancer. To lower their risk, they may choose to have surgery to

remove a breast, called a mastectomy.

• It helps to find disease. If we know we are at risk for a certain disease, we can get
  
  

tested for it. The earlier we find diseases like cancer, the easier they are to treat.

• It is a targeted therapy. Your genetic makeup can help guide your doctor to the
  
  

drug that’s most likely to work for you and cause the fewest side effects. Precision

medicine can even help you decide what dose of a drug you should take.

• It helps to monitor our response .physician can use precision medicine techniques to see how well your condition responds to a treatment.

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