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Personalized MedicineFinal
Personalized MedicineFinal
Personalized MedicineFinal
Joshua Hartman
University of Maryland Global Campus
USCP 615 Orientation to Graduate Studies
Caren Doyle
September 7, 2020
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patient’s own genetics, which can better predict drug effectivity, response and dosage. Patients
with the same disease respond differently to every treatment. It is time to advance from the “one
size fits all” and trial-and-error method of target-based treatments that respond differently to
each person, and support individualized treatments that can be much more effective using many
sources of data, including the patient’s data (Ho et al, 2020). Data coming from genetic
databases, medical records, tissues banks and others will be analyzed to find groups of
individuals who will respond to certain treatments and help tailor specific treatments for these
groups (Paneth & Cooper, 2020). This data has the benefit of being available anywhere at any
time, as an alternative to tests at a doctor’s office. There are many advantages to personalized
medicine, including less sides effects, better response and more accurate dosage. These benefits
make personalized medicine as a worthwhile and logical progression from target-based medicine
of today.
Personalized medicine can be used to identify, treat and dose specifically to the patient’s
needs. Genetic markers can be used to see the risk or the presence of disease before the signs of
symptoms. This could help focus on prevention or early intervention. An example of this is the
BRCA1 and BRCA2 gene, which when in a mutated form can be a sign of susceptibility to
breast cancer (up to 85%) compared to normal BRCA1 and BRCA2 genes (13%) (E. Ellsworth
et al., 2010). These women with the mutated genes can take preventative steps to increase
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chances of survival (E. Ellsworth et al., 2010). There are many biomarkers that when found can
help diagnose diseases early and increase outcomes. Prognostic markers can be used to see how
the patient’s disease will progress, predicting the best treatment (Paneth & Cooper, 2020).
Diagnostic tests can test for genetic characteristics that could improve outcomes instead of trying
different treatments for effectiveness. Pharmacogenomic tests can predict what treatment would
be best for the patient as genetics plays a role in the adverse effects a drug may have (THE
CASE FOR PERSONALIZED MEDICINE 2014 4TH EDITION, 2014). Doctors can use the
patient’s particular variability of these genes to find an ideal dose that lessens or prevents these
adverse effects.
Today, drugs are developed with a target, not the patient, in mind. The safety and
effectivity are identified in clinical trials, and the drug is then tried by trial and error by the
patients to determine which is most effective. With personalized medicine, the patient’s genomic
data can help decide whether a drug or treatment is compatible and effective. Clinical trials can
include or exclude ideal candidates for developing drugs by screening the genomes of potential
patients (Paneth & Cooper, 2020). This will lead to smaller and faster clinical trials, making to
the drug arrive on market more quickly. The new way drugs will be developed with personalized
medicine is one of a heuristic method rather than a linear one (Ho et al., 2020). Scientific data
will be integrated into a system that connects all the steps in the development process, from gene
discovery to Phase IV (THE CASE FOR PERSONALIZED MEDICINE 2014 4TH EDITION,
2014).
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Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) has the potential
of editing the genes that cause disease. CRISPR uses a guide RNA to target a DNA sequence,
then the Cas9 protein slices the DNA. Base editing is a new development that can change the
individual bases (A, C, T, G,) permanently correcting the deficient gene (Hong, 2018). Work is
also underway to make these changes reversible through a mutated version of Cas9 (Hong,
2018). Experiments can be run on the patient’s cells in a lab (ex vivo) instead of in the patient
itself to reduce risk. Animal subjects may also be used in the discovery process to apply to
humans. As with personalized medicine in general, clinical trials will use patients with the
genetic defect, saving the burden of testing a wide range of healthy volunteers (Hong, 2018).
One downside to using CRISPR is that cutting the genome activates p53, a DNA repair protein.
When CRISPR cuts and fixes the DNA, p53 tries to “fix” the DNA, making future gene editing
difficult (Hong, 2018). This can, however be avoided by editing cells that lack this protein,
Cancer treatments
discover more effective treatments or potentially a cure from personalized medicine. Harmful
DNA mutations cause abnormal control of replication, the growth of these cancer cells and the
growth eventually proves to be fatal. Finding the driver mutations and blocking their effects
could be a way to find a cure (Paneth & Cooper, 2020). Looking at the present however, genetic
tests have been used to match the patient to the best treatment. Drugs that might not have had
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positive results in clinical trials or with the global population can be used on small subgroups
with particular genetics that favor the drug (THE CASE FOR PERSONALIZED MEDICINE
2014 4 TH EDITION, 2014). Though it may not find the cure, personalized medicine can treat
Conclusion
Personalized medicine can change the way we approach treating disease. Every person
has different genetics and other variables that make the response to a drug or treatment
unpredictable. Using the patient’s genetic data can pair them with the ideal treatment, reaping all
the benefits while avoiding adverse effects. The entire process from drug development to clinical
trials can be streamlined to group patients by their genetics and provide the best drugs, testing
and response to every patient. The traditional trial-by-error method of medicine must be
examined and compared to the benefits of personalized medicine. Individualizing treatment with
personalized medicine can and most likely will promote a healthier word of individuals.
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References
E. Ellsworth, R., J. Decewicz, D., D. Shriver, C., & L. Ellsworth, D. (2010). Breast Cancer in the
https://doi.org/10.2174/138920210791110951
Ho, D., Quake, S. R., McCabe, E. R. B., Chng, W. J., Chow, E. K., Ding, X., Gelb, B. D., Ginsburg, G.
S., Hassenstab, J., Ho, C.-M., Mobley, W. C., Nolan, G. P., Rosen, S. T., Tan, P., Yen, Y., &
Zarrinpar, A. (2020). Enabling Technologies for Personalized and Precision Medicine. Trends in
Hong, A. (2018). CRISPR in personalized medicine: Industry perspectives in gene editing. Seminars in
Paneth, N., & Cooper, R. (2020, February 10). Will Precision Medicine Lead to a Healthier Population?
http://www.personalizedmedicinecoalition.org/Userfiles/PMC-
Corporate/file/pmc_case_for_personalized_medicine.pdf
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http://www.personalizedmedicinecoalition.org/Userfiles/PMC-
Corporate/file/pmc_case_for_personalized_medicine.pdf
Hong, A. (2018). CRISPR in personalized medicine: Industry perspectives in gene editing. Seminars in
Perinatology, 42(8), 501–507. https://doi.org/10.1053/j.semperi.2018.09.008
E. Ellsworth, R., J. Decewicz, D., D. Shriver, C., & L. Ellsworth, D. (2010). Breast Cancer in the
https://doi.org/10.2174/138920210791110951
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COOPER, R., & PANETH, N. (2020). WILL Precision Medicine LEAD TO A HEALTHIER
References