Precision Medicine: The Future of Data Driven Healthcare
Claudio Carini,
Global Head,
Pfizer Inc
Today, the practice of medicine remains largely empirical; physicians generally rely on patterns matching to establish the diagnosis based on a combination of a patient’s medical history, physical examination, and laboratory data. Thus, a given treatment is often based on physician past experience with similar patients; one consequence of this is that blockbuster medicines are prescribed for the “typical patient” for a specific disease. According to this paradigm, treatment decisions are driven by trial and error, and yet the patient may become victim of unpredictable side effects or poor (or no) efficacy for a drug that works in the majority of people affected by a specific disease.
The use of more biomarkers and companion diagnostics (CDX) will enable a shift from empirical medicine to precision medicine (PM). It is conceivable that in the immediate future clinicians will move away from the practice of “one size fits all,” shifting instead to basic tenants of PM (the right medicine, for the right patient, at the right dose, at the right time). This will no doubt improve patient care and reduce healthcare costs.
It is generally appreciated that the effectiveness of any treatment varies across a population. Patients and treatment responses differ because of variables, like genetic predisposition; epigenetic factors; early versus late stage of the disease; heterogeneity of cohorts and ethnicity; and slow versus fast metabolizers. These parameters have effects on whether a given individual will be a “good” or “poor” responder.
PM highlights the importance of coupling established clinical indexes with molecular profiling in order to create diagnostic, prognostic, and therapeutic strategies toward each patient’s needs. Recent advances have led to an explosion of disease-relevant molecular information, with potential advantages for patient care. PM is thus expected to provide a rapid acceleration in the development of next-generation pharmacotherapy. Currently, a p
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