The precision medicine revolution: putting the patient first
Precision medicine is putting the patient at the centre of healthcare. But what does precision medicine actually mean? And if you’re interested in using it in your research, where do you start? We’ve created a guide to help, explained here by Professor Stephen Holgate, MRC Clinical Professor of Immunopharmacology, who led the work.
Put simply, precision medicine aims to ensure that the right patient gets the right treatment at the right time.
Our genetics, together with our lifestyles and our environment, determine our health. Precision medicine is an exciting approach that will help to determine our individual risk of developing disease, detect illness earlier and determine the most effective interventions to help improve our health, whether they are medicines, lifestyle choices, or changes in diet.
The current approach to drug development assumes that all patients with a particular condition have the same response to a given drug. This means that all patients with the same condition receive the same first-line treatment, even though it may be only 30 to 60% effective. An alternative approach is urgently needed because currently we are giving treatments to patients in whom they either do not work or have side effects.
Precise medicine for complex diseases
Precision – also known as stratified or personalised – medicine is a move away from the ‘one-size-fits-all’ approach. It’s about sorting patients into subgroups with distinct disease mechanisms or according to their response to treatments.
But before you can you sort them into groups, you need to collect a lot of information. And if you’re collecting and analysing large amounts of data you want to make sure you’re collecting the right stuff. Along with clinical details of an illness, we need to know detailed information on what has gone wrong with cells at all stages from genes, proteins, all the way to how a cell functions, so that any defects can be corrected. That’s where the new framework comes in.
The MRC framework for stratified medicine research methodology provides guidance on the analyses of these large data sets. This includes finding specific gene changes in a particular cancer, which chemical signals have gone wrong in mental illness, which parts of our immune system go into overdrive in chronic inflammatory disorders such as arthritis, asthma and bowel disease, or what causes different types of diabetes.
Analysing these large data sets, collected from patients, will reveal new cellular processes that play roles in complex diseases. As a consequence, new targets will be uncovered to prevent and treat disease, tailored to the individual pathways operating in each patient.
Choosing the most effective treatment
Cancer is one condition where this approach is already delivering new and effective treatments. Today, a genomic or ‘molecular’ diagnosis is possible, which means that not only can we better understand the genetic base of an individual’s cancer, but this information can be used to help select the most effective precision treatment – resulting in greatly improved treatment responses, freedom from side effects and improved chances of survival.
We hope that the new MRC framework provides an accessible guide for researchers who are using a precision medicine based approach in their work.
Access The MRC Framework for the Development, Design and Analysis of Stratified Medicine Research