Personalized+Medicine

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 * Personalized Medicine **

=**Introduction **=

Personalized medicine is the process of tailoring medical procedures and treatment to individuals based their genome. This term has grown in convention over the past few years due to growth in new diagnostic tests and more understanding of the molecular basis of diseases. To understand how I am going to discuss all the possibilities that personalized medicine offers, I explain what makes personalized medicine so personal. Every person has a unique genome in their body. An individual’s health is based from their genetic variation. Personal practices like gene sequencing can spot mutations in a person’s genome that have been linked to cause a predisposition to certain diseases, such as cancer. Health care that is specifically designed for an individual is becoming increasingly popular. It is based on the idea of detecting certain abnormalities in a person’s DNA and using predicting techniques to evaluate risks that a person may have. There is becoming more of an acceptance in the field of personalized health. For years, generic health plans have been in place. This is because drug corporations are making billions of dollars peddling the same prescription drugs to everyone. People have been becoming increasingly tired with getting the same medication. Many people are reported with side effects from traditionally prescribed medication. [1] = = =**Personalized Medicine Today **=

Researchers have been able to identify many genes that have variations in them that have contributed to human disease. Discoveries have also been made that detect variability in the response patients have towards treatments. The biggest challenge that these scientists face is how to transfer new discoveries towards patients. The National Institutes of Health and the FDA have been working together and pooling their resources to grow their vision of personalized medicine. They are creating new therapies that enhance the process of choosing the ideal drug and the amount of that drug. Although we are still in the infancy stages of personalized medicine, there are many steps being made right now that will affect the future of tailored treatment. There are many obstacles that researchers face when determining which gene variations cause diseases. There is not enough evidence for exact gene detecting to make it plausible for private drug companies to invest. That is causing a lack of funding for researchers. Typically, when a new process in the drug market is discovered companies jump at the opportunity to invest. For companies to get involved, more research needs to be done. [2]


 * Technology for personalized medicine **

The Human Genome project was completed in 2003. Since then, there has been an increase in scientific discovery and increase in knowledge about genomes. Technology has become increasingly more advanced and genetic information is now accessible through platforms, such as a sequencer, that can analyze genetic variation. Computing with Cloud is a way to process large amounts of data used for sequencing. This is important because a cloud-based platform can be analyzed in a matter of minutes, where as it used to take days. The ability to share this data between the patients, scientists and physicians allow for obtaining the most knowledge for what the next step should be, concerning treatment. [4] The image below shows just how far we have come in the past few decades, concerning genetics. From discovering what DNA is to the entire human genome being sequenced. Technology is going to continue to advance and make personalized medicine more available.



The ability for a physician to look at a patient by more than just their phenotypes is essential for diagnosing a specific treatment. Genotyping is the ability to attain a person’s unique DNA sequence using “biological assays.” [5] An assay is a procedure for assessing or measuring the amount of a certain entity you are trying to find. By having this information, a patient’s genome can then be compared to a referenced genome. Certain private companies have been using this technology. Companies such as 23 And Me and Navigenics give gene sequencing to consumers for a relatively low price. This information can be applied to specific treatment. An individual’s genetics can tell physicians how well a person will respond to a treatment. The companies that I have just mentioned are private and do not work directly with physicians. So, a person would have to inform the physician of their predispositions because those tests would be very expensive in a doctor’s office. Pharmacogenomics is when a person’s genome provides tailored prescriptions. The idea behind drugs is that it should have the same effect for everyone. There are numerous factors that need to be considered. The ability to process genetic information for a person will prevent any side effects that may occur. [6] The goal for diagnosing medical problems is to prevent any disease by diagnosing before that problem can arise. An example would be for women who have mutations in the BRCA1 and BRCA2 gene. Women have been genotyped for these genes and have had preventative measures taken [7]
 * 1) =**Diagnosis for Treatment **=

=** 2.The Development of Drugs **= The ability of having a person’s genome is extremely helpful when identifying which drugs to take. Drugs that are unsuccessful for a population can still be successful for someone who responds positively to the chemicals within them. It is common in medicine for physicians to use a “trial and error” technique until they find the correct treatment. [8] A person’s genomics will allow a physician to have more information when choosing their patients drugs. An example would be for the drug tamoxifen. It is a drug that is often prescribed to women wo have ER+ breast cancer. Though this drug is commonly used, 65% of women developed a resistance to it. After much research by David Flockhart, a medical researcher who was an innovative leader in personalized medicine, he discovered that the women who were developing resistance to tamoxifen have a mutation in the CYP2D6 gene. This gene encodes metabolizing enzymes. This meant that tamoxifen was not breaking down correctly and making treatment ineffective. [9]

=** 3.The Genomics of Cancer **= <span style="font-family: Arial,sans-serif; font-size: 12pt;">Cancer is one of the biggest medical problems that is looking for a solution. The treatment of cancer involves radiation and/or prescription drugs. Many times, the outcome of a person’s cancer depends on the luck of their treatment and the patient’s motivation to beat cancer. The truth is that the chance of survival is based on if the treatment is suitable to a person or not. For some people, you may not know that the treatment is good for you before it is too late. <span style="font-family: Arial,sans-serif; font-size: 12pt;">Recent years of research has shown an increasing awareness to variations within tumors and therefore variation within treatment. Targeted treatments are becoming the focus of personalized medicine for cancer medicine. Having a targeted treatment means that a specific cancer gene is targeted to prevent growth. Once researchers target the specific gene, they create drugs to target these areas. [10] =**<span style="font-family: Arial,sans-serif; font-size: 12pt;">The Future of Personalized Medicine. **=

<span style="font-family: Arial,sans-serif; font-size: 12pt;">Research for advanced therapies are underway. The FDA approved a “treatment for patients with a juvenile form of cancer” [11]. A patient had hi <span style="font-family: Arial,sans-serif; font-size: 12pt;">s or her cells removed and they were altered to attack cancer cells. It is predicted t <span style="font-family: Arial,sans-serif; font-size: 12pt;">hat in a few short years, parts of the DNA that can cause diseases will be cut out and replaced with DNA that is healthy. This is the stuff of science fiction. The ability <span style="font-family: Arial,sans-serif; font-size: 12pt;">to replace damaged DNA with a healthy strand is no longer science fiction.

<span style="font-family: Arial,sans-serif; font-size: 12pt;">Personalized medicine with impact the future of healthcare as we know it. The typical low productivity that healthcare is associated with will become a thing of the past. Cost and time will improve and other innovations such as health detectors, and artificial intelligence will advance personalized medicine. The cost of sequencing an entire human genome is illustrated below. That’s right. It is proj <span style="font-family: Arial,sans-serif; font-size: 16px;">ected that human genome sequencing will cost $1.00 or less by the year 2025.

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<span style="font-family: Arial,sans-serif; font-size: 12pt;">**<span style="font-family: arial,helvetica,sans-serif; font-size: 1.4em;"><span style="font-family: Arial,sans-serif; font-size: 12pt;">Conclusion **

<span style="font-family: Arial,sans-serif; font-size: 12pt;">Technology, discovery, and a patient’s yearning for specialized care will propel personalized medicine into all healthcare aspects. No longer are the days of trial and error. With technology making genomic sequencing very cheap, a person’s genome can be stored within a cloud data base and give physicians the best knowledge available to make the best decision possible for treatment. The place that personalized medicine is in now is sequencing and testing. There are many trials going on to put sequencing to its best use. The future looks bright for personalized medicine and soon, your treatment will be about you. =**<span style="font-family: Arial,sans-serif; font-size: 12pt;">References **=

<span style="font-family: Arial,sans-serif; font-size: 12pt;">10.[] <span style="font-family: Arial,sans-serif; font-size: 12pt;">11.[] <span style="font-family: Arial,sans-serif; font-size: 12pt;">12.[] <span style="font-family: Arial,sans-serif; font-size: 12pt;">13.Zoon CK, Starker EQ, Wilson AM, Emmert-buck MR, Libutti SK, Tagrea MA. Current molecular diagnostics of breast cancer and the potential incorporation of microRNA. Expert Rev Mol Diagn. 2009;9:455–67. <span style="font-family: Arial,sans-serif; font-size: 12pt;">14.Macklin R. Double standards in medical research in developing countries. Cambridge: Cambridge University Press, 2004. <span style="font-family: Arial,sans-serif; font-size: 12pt;">15.Farlex Perlegen Sciences to Analyze Genetics of Common Diseases in Postmenopausal Women; Collaboration With Women's Health Initiative Funded by the National Institutes of Health. 2005. <span style="font-family: Arial,sans-serif; font-size: 12pt;">16.Business Wire. The University of Cambridge, Cancer Research Technology, Cancer Research UK and Perlegen Sciences Collaborate to Analyze Thousands of DNA Samples from Breast Cancer Patients. 2005. <span style="font-family: Arial,sans-serif; font-size: 12pt;">17.GSPP. 2006. The Genomics and Personalized Medicine Act of 2006. <span style="font-family: Arial,sans-serif; font-size: 12pt;">18.Genomeweb. Scripps, Navigenics, Affy, and Microsoft Launch Long-term Study on Behavioral Effects of Personal Genetic Testing. <span style="font-family: Arial,sans-serif; font-size: 12pt;">19.Ryon. Meditations and Musings of a Young Cancer Researcher; 2013. Why Gene Patents Matter for Personalized Medicine. <span style="font-family: Arial,sans-serif; font-size: 12pt;">20.Lenehan P, Gliklich R, Worzel B, Freshley J. Cambridge, MA: Advanstar Publication; 2005. Rescuing Drugs Through Personalized Medicine. <span style="font-family: Arial,sans-serif; font-size: 12pt;">21.Heinemann V, Douillard JY, Ducreux M, Peeters M. Targeted therapy in metastatic colorectal cancer – An example of personalised medicine in action. Cancer Treat Rev. 2013;39:592–601 <span style="font-family: Arial,sans-serif; font-size: 12pt;">22.Bonislawski A. Verisante This Year to Launch Point -of-Care Biomarker-Based Skin Cancer Test. 2011.
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