Research Profiles - Personalized medicine: Tailoring the treatment to the individual
When it comes to the practice of medicine, one size has never fit all.
Ever since Hippocrates, health care providers have been observing patients’ symptoms and physical characteristics in selecting specific therapies.
Over the past 20 years, however, developments in genomics and proteomics have made it possible to decode the "genetic signatures" of diseases. Researchers now have better tools to identify biomarkers – evidence in our blood and tissue, cells, molecules, genes, enzymes and hormones – to predict the possibility of disease, prevent it from occurring, diagnose it more accurately and treat it more precisely.
The move toward tailoring treatment to fit the individual is called personalized medicine and it holds the promise to transform the delivery of health care.
To help catalyze advances and innovations, CIHR has launched a new strategic initiative in personalized medicine. The goal is to engage investigators in biomedical, clinical, epidemiology, population health, health economics, ethics, health services and policy research to exploit opportunities to ease the burden of disease through the application of personalized medicine approaches.
Personalized medicine has already arrived at the clinic. Drugs such as Herceptin, which targets the human epidermal growth factor receptor-2 that is over-expressed in 25–30% of women with breast cancer, and Gleevac, effective for people with a specific type of chronic myeloid leukemia, are the most notable examples. Outside of the cancer field, the practice of prescribing the anticoagulant Warfarin to cardiovascular patients has been significantly refined through the use of genetic tests to determine appropriate doses.
More applications of personalized molecular medicine may soon lead to better health outcomes, improved treatments, and a reduction in toxicity due to variable or adverse drug responses.
This month we feature three CIHR-funded investigators who are doing vital research in the field of personalized medicine:
- Adding up the unknowns: The University of Western Ontario's Dr. Gregory Zaric leads a three-year study to weigh the benefits and costs of implementing two recently developed genetic tests to identify primary sources of metastatic carcinomas.
- Cost-effective and compassionate: Dr. François Rousseau of Laval University shows how computer simulations can sort out the best strategies for prenatal screening for genetic disorders.
- Rethinking cancer testing: Genomics is not only changing how diseases are diagnosed and treated, it's challenging new models of interaction between public research and biotech companies, and the resulting applications for the health care system, according to Dr. Peter Keating of the University of Quebec at Montreal.