There are people who will die of cancer this week even though there are drugs that could help them. At the same time, hundreds of patients will undergo cancer chemotherapy that, while debilitating and expensive, will not cure them of their disease.
While cancer is a formidable foe, there is a way to improve patient care and prognosis immediately. Researchers in Finland, Sweden and Spain have modified ex-vivo testing of cancer cells with significant results. Their approach is far more “personalized” than traditional precision medicine. Their results are striking. They provide a missing link between genomics-based mutation determination and clinical efficacy.
Precision medicine (also referred to as “personalized medicine” or PM) appears to many patients, doctors and researchers to be a golden highway from disease identification to cure. The idea of interrogating the genome of a particular cancer to determine its Achilles heel is intuitively satisfying and understandable. There are, however, significant problems. First, PM is neither personalized nor precise. PM strives to identify the appropriate biomarker (usually a DNA mutation but proteins, peptides and metabolites can stand as biomarkers as well) to categorize the patient as a member of a specific group of patients. The patient is treated with a drug that has shown positive results on previous members of the group. In other words, personalized medicine is actually population-based medicine.
In contrast, the method described by researchers at the Institute of Molecular Medicine, Finland, determines empirically the best treatment with what they call “individualized” medicine to differentiate it from PM. They follow the determination of the appropriate therapy with detailed genomics-based analyses of the patient and the cancer to develop an understanding of the mode of action of the therapy. By integrating the cure with an understanding of the genetic mutation, they have changed the existing paradigm and created “individualized system medicine.” The power of the individualized system medicine approach includes the ability to more quickly look at mechanisms of action, assess drug combinations, understand drug resistance, position and de-risk drug candidates and provide more rapid drug repositioning in a way that has not been previously achievable.