Genomics as a Final Frontier, or Just a Way Station

Abigail Zuger in The New York Times:

The medical world is holding its breath, waiting for the revolution. It will be here any minute. Definitely by the end of the decade. Or perhaps it will take a little longer than that, but seriously, it’s right around the corner. More or less. That’s the genomics revolution, with its promise of treatment focused on the individual rather than the group. At last, patients will be more than the product of their age, sex, ethnicity, illnesses and bad habits; treatments will be aimed like a laser at their personal genetic particulars, and if those genes are not quite what they should be, then those genes will be fixed. Over the last few years, various breathless visions of this therapeutic future have been written out for public admiration. A particularly readable and comprehensive version can be found in Dr. Eric J. Topol’s new book, “The Creative Destruction of Medicine.”

Dr. Topol, a cardiologist and researcher at the Scripps Research Institute with the energy of 10 (if his prose style and his honor-laden biography are any indication), dispenses in short order with our current population-based medical strategies. They are wasteful and inexact, he points out, often marginally beneficial to the group and downright harmful to the individual. He presents an array of far better ideas, a few now actually being practiced in rudimentary form. These include pharmacogenomics, in which specific genes that govern responses to medications are routinely assayed, and cancer treatments that probe tumors for specific genetic targets rather than relying on standard chemotherapy. But that’s not all: Dr. Topol also points out that soon a person’s precise genetic data will be augmented by an extraordinary wealth of other digital data (provided by, say, the continuous monitoring of blood pressure, pulse and mood, and a variety of ultra-precise scans). The outcome will be nothing short of a new “science of individuality,” one that defines individuals “at a more granular and molecular level than ever imaginable.”

More here.