Wed. Apr 21st, 2021

Is precision medicine On health care, technology and controversy erosion. The idea of ​​improving a patient’s biological information and using tailor-made treatments has gone from niche to mainstream, with President Barack Obama calling for a $ 215 million investment in precision medicine During your state address In January. But as the practice gains popularity, experts point to several issues that the medical community has yet to tackle.

While a genome sequencing costs around $ 5,000 to $ 95,000 now to $ 2000 – genetic information generated from sequencing needs to be analyzed, interpreted, shared, and stored. This means that precision medicine is more than simply crafting an individual cure; Contains Big data, Privacy issues, drug development and finding a way to pay for it.

Dr. Geoffrey Zinsberg, founding director of the Center for Applied Genomics and Precision Medicine at Duke University Medical Center, Drs. Elizabeth M. McNally, director of the Center for Genetic Medicine and Medicine and Biomechestry, is a professor in the Department of Molecular Biology. And Genetics at Northwestern University Feinberg School of Medicine, and Chief Scientific Officer at Dana-Farber Cancer Institute and Linde Family Professor of Medicine at Harvard Medical School, Drs. Barrett j. US News and World Report Hospital tomorrow Conference in the nation’s capital. The session, “The Precision Medicine Revolution”, was overseen by Lillah M. Alphonse, managing editor of US News and World Report.

“Genetic application to medicine is not something that is completely new,” Ginsberg said, adding that the term “pharmaco-genetics” was coined in 1959. But since then, the field has changed, going from one that is very genome-based. There is more than one health care and health care system based, ”he said.

All types of information are influencing how patients are diagnosed and treated, he explained, in addition to genomic sequencing. Advanced medicine, mobile health, e-lenses, learning health systems, patient engagement, big data, and analytics all have the role of precision medicine.

When we talk about precision medicine in relation to genetics, McNally explained, we’re talking about advances since 2007, McNally said, which is when we started generating “massive amounts of sequels.” And “we were beginning to appreciate for the first time” how genetically different we all are from each other. ”

A cardiologist, McNally pointed out that in the areas of heart failure and arrhythmia, doctors now know that there are many families who bear a genetic risk for developing heart problems, and they use that information in the management of those patients We do.

“We’ve definitely saved lives using genetic information,” she said.

So “what is genetic reality?”

“We’re all a mixture of common and rare variation,” she said, “yet sorting through that information is an incredibly good predictor of what the results are.”

When it comes to treating cancer, there are a large number of genetic variants that are already known, and every diagnosis is a tissue-based diagnosis, said Rollins, who focused on the relationship between inflammation and cancer. is. “So, for us, the question is not so much, ‘Should we implement an accurate cancer therapy program at a cancer therapy center?’ The question is, ‘How do you do it?’

The answer is simple, though its implementation is not: “Tomorrow’s hospital will have to find some way to conduct broad-based genomic testing on every patient who visits their hospitals.”

Being able to collect data on many more individuals could ultimately help the medical community to treat the disease on a broader scale, the panelists agreed.

“When we are talking about the effects on public health, we are talking about risk and risk modification,” Rollins explained. “It has always been very striking that most people who smoke do not have lung cancer, and yet single interventions to cease smoking have had an impact on broader public health.”

A better understanding of which individuals cannot repair the damage caused by smoking – and which can – will allow the medical community to devise more accurate risk-modification programs for patients, Rollins said .

Nevertheless, Zinsberg warned, significant challenges remain, including acceptance, access to interpretation, electronic health record integration, data liquidity, outcome studies, and of course reimbursement.

This is not a revolution, he said. This is an evolution.

“Precision medicine is a team sport,” Ginsburg said. “Precision Medicine will promote the forums themselves and encourage participation. Don’t be afraid to be part of that dialogue.”

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