Moving Towards Individualized Medicine For All

Bob Grant in The Scientist:

Personalized medicine. Precision medicine. Genomic medicine. Individualized medicine. All of these phrases strive to express a similar vision—a reality where physicians treat based on each patient’s unique biology. The concept is poised to revolutionize clinical and preventive care. But even as the technologies helping to birth this new breed of medicine mature, the semantics surrounding the phenomenon are still experiencing growing pains. So, what should we call it? For a long time, “personalized medicine” was the preferred nomenclature. In the popular press especially, this was (and often still is) the go-to phrase to describe the medical paradigm shift that is underway. But about eight years ago, a committee convened by the director of the National Institutes of Health recommended jettisoning “personalized medicine” and replacing it with “precision medicine.” This term, the committee argued, “is less likely to be misinterpreted as meaning that each patient will be treated differently from every other patient.”

For now, the closest we’ve gotten to the distant goal has been bucketing patients into subgroups, most often on the basis of their genetics. “Genomic medicine” characterizes this current state of affairs most directly, but the term seems to ignore other unique characteristics—environ­mental factors, lifestyle, microbiomes, etc.—that can also be used to tailor a treatment to a particular patient.

This month’s Reading Frames author Eric Topol, founder and director of the Scripps Research Translational Institute, wrote in a 2014 Cell review article that all of these phrases should be left in the dust, advocating for the use of “individualized medicine” in their place. The individual, he argued, is at the epicenter of this new approach to clinical care. “Be it a genome sequence on a tablet or the results of a biosensor for blood pressure or another physiologic metric displayed on a smartphone,” Topol wrote, “the digital convergence with biology will definitively anchor the individual as a source of salient data, the conduit of information flow, and a—if not the—principal driver of medicine in the future.”

More here.