Take Charge of Your Health - Getting It Right: Precision Medicine and Precision Health

Precision medicine is a data driven, knowledge driven, compassion driven,
social intelligence driven, genetically compatible
tailoring treatment and prevention systems for individual patients.
-Amit Ray

          According to the National Institutes of Health, Precision Medicine is described as “an emerging approach for disease treatment and prevention that takes into account individual variability in environment, lifestyle and genes for each person.” The aim of precision medicine is to match treatments with individual patients considering their genetic makeup, medical history, test results and other distinctive characteristics. Instead of a one-size-fits-all approach, precision medicine’s goal is to provide the right treatment for the right patient at the right time. Herceptin is considered the first of the precision medicine drugs though at the time of its approval by the FDA (1998), the use of the term was minimal.

          A quick primer from St. Jude Children’s Research Hospital on precision medicine and genomics is helpful for most of us who may have completed our biology classes in prior decades. First, our bodies are made up of building blocks known as cells. Our cells contain chromosomes, which are made up of DNA. Our DNA is organized into smaller units called genes. And, genes are the instructions that tell our cells how to function. The complete set of human genes is called our genome.

          Over years of clinical research and practical application of treatments for a number of diseases, it has become clear that some people respond better to certain types of treatment than others. A way to further stratify these findings has been to go back to the individual’s genome and see what is happening.

          In precision cancer medicine treatments may be matched to the genetic abnormalities of the tumor, in other words, targeting the changes in the DNA code that drives the cancer’s uncontrolled growth. Sometimes this therapy may involve adding functional copies of genes to replace ones that are missing or changed. Another type of treatment changes the regulation of genes that are over or under active. Gene therapy, a form of precision medicine, can also be used to improve the immune system’s ability to recognize cancer cells, so that the immune system can attack them. A recent approach to changing the patient’s immune cells (T-cells) is CAR T-cell therapy. In these instances, the patient’s own T-cells are separated out and altered in the lab to express a special receptor molecule called a chimeric antigen receptor (CAR) on its surface. These CAR T-cells facilitate a disease-specific immune response that ‘turbo-charges’ the effectiveness of the patient’s natural response.

          Meanwhile, precision health, another term often in today’s news, takes a big-data approach to disease prevention and detection. Precision health focuses on the various factors that help maintain health throughout life. Collecting genomic information of the population should help population health studies in the future, with a goal to help prevent diseases at an early stage. Megan Mahoney, MD, Chief of General Primary Care, Division of Primary Care and Population Health in the Department of Medicine at Stanford University explains, "We're shifting the focus upstream to promote health and well-being before a patient becomes ill...Precision health focuses on the use of scientific research and genetic testing advances to predict what diseases will most likely occur in patients, then initiate and individualize interventions to prevent these diseases before they strike."

          Precision health can also reduce the cost of treatment by decreasing repetitive administration of medicine and mitigating the side-effects associated with them. The goal of precision health, like precision medicine, is to do what works best for patients.

As always, join us on the Health-E³ website blog page. We look forward to hearing your thoughts and experiences. Feel free to ask questions about anything on the website or suggest ideas for additional helpful information. And remember, it's up to you to Take Charge of Your Health.