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Precision Medicine: PROGRESS AND FUTURE DEVELOPMENTS

“Tonight I’m launching a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetes — and to give all of us access to the personalized information we need to keep ourselves and our families healthier”

Barack Obama, 20 Gennaio 2015

 

Several years have passed since the former President of the United States delivered this message in the traditional speech to the nation, generating a considerable echo in the ears of the millions and millions of people listening.

Precision medicine expresses a new concept in healthcare, based on individual differences and which takes into account the genetic, environmental and lifestyle variability of individuals. The main objective is to combine genetic information and clinical data to personalize treatments, according to the characteristics of the patient.

With the sequencing of the human genome, space has been made for a new way of investigating cellular mechanisms. Disciplines such as: epigenetics, transcriptomics, proteomics and metabolomics have produced a vast amount of information, which allow an increasingly precise characterization of the patient.

According to the National Institutes of Health, applying such approaches to medicine could extend the treatment possibilities to many still intractable pathologies, for which a target marker to be specifically targeted with a drug has not yet been identified.

The concept of precision medicine, however, is not that recent.

Already in the late nineteenth century, the Canadian doctor Osler introduced this thought after observing the great variability existing between individuals.

The identification of blood groups (which took place around 1900), together with other important events, such as the discovery of an abnormal response to some drug treatments by some individuals, helped to reinforce the idea of ​​human variability.

Despite these evidences, medicine has continued for a long time to have a population approach in the search for therapies for patients, favoring, in the choice of the most effective drugs, the average response to therapy rather than the particular case.

Only in recent times has precision medicine begun to have applications in clinical practice, particularly in the oncology field, where it seems to be achieving very encouraging results.

The question remains how widespread is the revolution that accompanies precision medicine. How many doctors, institutes, governments are oriented towards the new therapies of the future?

One of the first to make a commitment to the development of precision medicine, as anticipated, was the American government. The Obama administration established the Precision Medicine Initiative by engaging patients, doctors, researchers and leaders in the pharmaceutical industry and by defining new research challenges.

In Europe, however, things are a bit slow despite the fact that already in 2013, the European Commission had begun to reflect on its potential, emphasizing the role of new technologies in creating personalized care for the individual patient.

Precision medicine employs modern methods to manage immense amounts of data and harnesses all technological knowledge to broaden biomedical discoveries.

Patient care should always be centered on the person, sometimes clinically individualized and, in the presence of certain genetic characteristics, precision.

Molecular drugs represent an essential element of personalized medicine, precisely because they are very effective on a specific disease and for a particular group of patients for which they have been designed.

It is therefore of fundamental importance to identify biomarkers, that is biological measurements for predicting the risk of disease, early diagnosis, choice of therapy and evaluation of its effectiveness. Currently very effective treatments, such as those for some forms of chronic myeloid leukemia and lung cancer, are linked, in fact, to biomarkers capable of predicting the response.

Oncology is not the only clinical area able to take advantage of the progress achievable thanks to precision medicine; rather it seems to be destined to embrace other areas of medicine such as: cardiology and autoimmune diseases (among these, the most widespread is Rheumatoid Arthritis).

Today, assessing the individual characteristics and risk factors of each patient allows us to acquire essential clinical information which, over time, allows us to develop effective individual therapies.

iCareX, with the exploRA Test, accompanies precision medicine towards autoimmune diseases, with particular attention to Rheumatoid Arthritis.

ExploRA (explore Rheumatoid Arthritis) is the world’s first transcriptomic test that allows rheumatoid arthritis (RA) patients to better understand and manage their disease.

Important health goals could be achieved not by focusing so much on conventional methods in use today, but by addressing more effectively the health inequalities of the individual.

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