Precision Medicine: Is the Future Already Here?
By Daniela Chueke Perles
Precision medicine is the future of health. The first thing it has come to change is the way research is done; the second thing is the way medical treatments will be provided in a few years’ time. Researchers are already using genome sequencing data to learn more about why people become ill or stay healthy and what makes them unique and unrepeatable. This is why precision medicine is also known as “personalized medicine,” although personalized medicine is a concept that comes from Hippocrates, only super-specialization in medical areas led to a health model that currently treats diseases instead of people.
In 2015, the US president, Barack Obama, announced an ambitious precision medicine research program with an investment of $1.5 billion dollars, which sought to establish a database for sequencing the genome of one million Americans. The plan, known as “All of Us” and implemented by the National Institute of Health, began creating one of the largest and most diverse health databases of its kind in 2018.
Since then precision medicine began to gain prominence in Latin America too through various players: pharmaceutical companies, researchers, patients, legislators, government, and doctors, who view this new paradigm as an opportunity to give their patients better treatments and provide them with the cures they need.
Although a plan as ambitious as the one being implemented in the United States does not yet exist, governments are beginning to focus on this area, which is seen as the medicine of the future.
Data are central to precision medicine
One example of the risk involved in collecting data as sensitive as that of the human genome is the recent genetic data theft of more than a million people from the company 23andMe. On October 6, the company revealed that the data of a million customers are being sold on the deep web, with their personal information and the genetic links to their ancestors.
However, the promise of precision medicine is far more encouraging than the challenges that arise from data security. This was made clear in the panel held on the topic in Buenos Aires, convened by AmCham (the American Chamber of Commerce) during the Health Forum.
Taking part in the precision medicine panel, Leticia Murray, CEO of AstraZeneca Cono Sur, remarked that “precision medicine aims to have the right medication, at the right time, for the right patient.” Murray also said that the company is focusing on this approach and that, in the future, one-size-fits-all medications will fade into the background.
Since regulatory aspects of health are crucial to allowing patients access to treatments, Senator Guadalupe Tagliaferri also spoke about the importance of legislation favoring both research and public-private partnerships, as well as patient access to technological advances with respect to health.
Representing the interests of cancer patients, María de San Martín, head of Fundación Donde Quiero Estar, highlighted the importance of getting patients the treatments they need and the fact that greater work is also needed in the area of prevention, to prevent the high health system costs of treatments for diseases in very advanced states.
Leticia Murray said the company is focusing its research efforts on innovation from the perspective of precision medicine. “This is how we think about and innovate the AstraZeneca portfolio: 80 percent of the portfolio of products in the pipeline from AstraZeneca are coming precisely from this approach because we believe that it is how comprehensive patient care will evolve, focusing on medicine that is much more personalized and making health systems much more sustainable,” Murray said. She continued, “If you continue to produce one-size-fits-all drugs then of course some of them can be very effective for certain types of patients, whereas they will be of no use to others. With this approach, we will ensure that the resource goes to the patient who will benefit from this treatment and ideally find it at the right time, and that’s what diagnosis is for.”
Is precision medicine the same as personalized medicine?
Yes, Murray replied, given that that is where it is heading. “It begins in very highly specialized therapeutic areas, like oncology, where we observe target molecules, that is, those related to a certain type of genetic mutation that the patient has. There is also a lot of innovation in studying and watching, particularly with things like cell therapy or medicines that are already individualized where we are now beginning to see medications consistent with this area; future scientific developments are extremely interesting,” she said.
AstraZeneca has signed a collaboration agreement with Roche and Novartis to promote precision medicine in Latin America.
Anabella Fassiano, a PHC Ecosystem partner of Roche, told Global Health Intelligence what the laboratory is currently working on. “The pooling of medical knowledge, digitization, and the science of data analysis is revolutionizing medicine. We are collecting unique knowledge of human biology with new ways of analyzing data.”
She also mentioned that many of the efforts are aimed at tackling cancer. “In oncology, molecular knowledge enables us to personalize treatment according to the specific genome profile of the patient’s tumor. Cancer care is becoming increasingly complex as more actionable genes are identified and treatment options increase. In 2017, there were more than 700 molecules in advanced development, 90% of which were targeted therapies. So in order to cope with the growing complexity and understand precision medicine’s potential, a strategy of continuous evolution is required for clinical diagnosis and decision-making,” Fassiano says.
What developments is precision medicine having in Latin America?
In the specific case of cancer, genome sequencing could be highly useful to patients in order to benefit from treatments based on therapies that target the molecular profile of their tumor. Sequencing helps to provide better expectations for patients by expanding treatment possibilities, as it detects clinically relevant alterations that might not be detected by other techniques and relates them to potential therapeutic options. On the way toward bringing personalized medicine to patients, a new therapy that acts against multiple types of cancer was recently approved in Argentina. It is a drug that is indicated according to the tumor’s genetic alterations, wherever it may be lodged.
Health systems in Latin America are facing challenges such as population aging, higher prevalence of chronic diseases, infrastructure problems, and resource scarcity, exacerbated by the COVID-19 pandemic. FutureProofing Healthcare is an international initiative backed by Roche and designed by leading independent experts to promote conversations around the interventions needed to get health systems ready for the future. In 2021 the results of its Personalised Health Index in Latin America were published, the first resource of its kind to provide a unique overview of the current state of ten of the region’s health systems. The countries involved in the Personalised Health Index in Latin America are Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Panama, Peru, and Uruguay.
These ten Latin American countries were assessed and classified based on various aspects related to personalized medicine, such as personalized technologies, health services, health information, and policy context.
As Fassiano says, the region still has a way to go to incorporate precision medicine. “The implementation of data-driven strategies, together with improvements in infrastructure and health policies, are key aspects to maximizing the potential of precision medicine in the region. Personalized medicine is presented as a tool to make the use of existing resources more efficient and, therefore, improve the effectiveness of medical care, despite the as-yet unresolved challenges in other aspects of Latin American life,” she concludes.
What is precision medicine
Precision medicine is the promise of going back to putting the patient at center stage.
Technologies: precision medicine employs new technologies like DNA sequencing (also known as genome sequencing), bioinformatics, and personalized medicine.
Applications: the treatment of cancer and genetic diseases are some of the fields of medicine in which precision medicine is advancing the most.
Benefits: the main benefit of precision medicine is improved treatment efficacy as it is aimed at a specific patient for their specific situation.
Challenges: some of the challenges of precision medicine, given that it requires highly sensitive data such as people’s genome sequencing, relate to ethical and privacy issues. In the wrong hands, these data could be used to cause harm rather than benefits.
Who can benefit from precision medicine
To make sure cancer patients can benefit from the latest advances in treatment requires a strategy of continuous evolution for clinical diagnostics and decision-making that:
✓ Identifies clinically relevant genome alterations and immunotherapy response biomarkers
✓ Supports clinical decision-making
✓ Helps personalize patient treatment plans
A comprehensive genome profile assessment is important in guaranteeing that patients are able to benefit from the latest treatment innovations.
Contact us if you would like to learn more about the most relevant topics in the Latin American medical sector. GHI has customized data and studies that will help you better understand the future of healthcare in the region.