The promise of personalized medicine — safer and much effectual treatments tailored to each individual’s assemblage and needs — isn’t being afloat met due to the fact that of challenges associated with its implementation successful objective practice.
In a special report published contiguous successful JCO Precision Oncology, we and our colleagues from Diaceutics, the Personalized Medicine Coalition, and Reservoir Communications supply the archetypal in-depth look astatine the efforts of United States wellness systems to deploy perchance paradigm-shifting drugs that tin beryllium utilized to people circumstantial familial vulnerabilities successful crab cells.
The survey focused connected a cohort of radical with non-small compartment lung crab due to the fact that this illness presents large opportunities for a genetically personalized approach, with much than 70% of non-small compartment lung crab tumors having familial alterations known to person outsized effects successful driving tumor growth. In galore cases, doctors tin usage disposable therapies that people those genes, which are much communal successful cancerous cells than successful steadfast ones. This attack is designed to inhibit oregon halt crab maturation portion minimizing harm to steadfast cells.
advertisement
Genetically guided personalized medicine tin marque a large quality for patients with lung cancer. For example, individuals with lung tumors containing mutations successful genes known arsenic EGFR and ALK who person genetically targeted therapies tend to unrecorded longer than those who bash not person targeted therapies. In fact, the National Cancer Institute partially credits targeted therapies and immuno-oncology drugs for much than a decade’s worthy of declining decease rates for radical with lung cancer.
Yet these therapies are being woefully underused.
advertisement
Our JCO Precision Oncology study examined Medicare claims and laboratory information from 38,068 radical diagnosed with precocious non-small compartment lung crab successful 2019. Due to difficulties successful investigating and attraction astatine each of the seven steps successful the precision oncology pathway, personalized therapies benefitted lone astir one-third of the individuals whose tumors whitethorn person contained genes that could beryllium targeted by disposable therapies.
In this study, the gaps successful objective signifier that constricted the anticipation of personalized medicine included failures to bid tests to place genes that whitethorn beryllium associated with targeted attraction options, failures to cod the insubstantial oregon humor samples needed for those tests, errors successful collecting oregon processing insubstantial oregon humor sample, investigating results that were inconclusive oregon provided mendacious negatives, extended turnaround times for reporting results that prompted doctors to prescribe one-size-fits-all treatments for patients who did not person the clip to hold immoderate longer, and failures to prescribe the due therapies to patients who tested affirmative for actionable biomarkers.
The results suggest that standardizing trial ordering and processing and creating broader acquisition initiatives for aesculapian professionals tin assistance guarantee that much radical payment from the latest developments successful personalized medicine. The implications spell beyond non-small compartment lung cancer. According to the Personalized Medicine Coalition’s latest estimates, much than 75,000 familial investigating products and 300 personalized medicines are connected the marketplace for radical with aggregate types of cancers, familial uncommon diseases, and a scope of chronic and infectious diseases.
Doing much to instrumentality afloat vantage of personalized medicine makes consciousness from some objective and economical perspectives. In 2015, researchers from Intermountain Healthcare reported connected the outcomes and costs associated with their implementation of genetically guided personalized medicine among a cohort of 36 radical with precocious crab compared to a power radical of 36 others with precocious crab who received modular chemotherapy. Those treated with personalized medicine survived longer: progression-free endurance was 23 weeks for the attraction radical and 12 weeks for the power group. Equally important, the attack did not summation attraction costs, which were $3,204 per week successful the targeted radical vs. $3,501 successful the power group.
A 2019 economic modeling study connected the cost-effectiveness of multi-gene sheet sequencing among a cohort of 5,688 radical with precocious non-small compartment lung crab suggested that multi-gene sequencing tests could present adjacent much worth if individuals with trial results identifying actionable familial mutations consistently received genetically guided treatments.
Given the signifier gaps revealed by the JCO Precision Oncology study, 1 tin lone ideate what the representation of objective adoption looks similar successful illness states wherever personalized medicine is adjacent little established, adjacent though it is arsenic promising for patients and their families.
As the 20th day of the completion of the Human Genome Project approaches adjacent year, it is becoming progressively wide that a paradigm displacement toward personalized medicine won’t hap conscionable due to the fact that caller tests and treatments person go available. Reaping the afloat scope of personalized medicine’s benefits volition necessitate much focused attraction connected updating policies and practices that optimize the transportation of personalized wellness care.
Daryl Pritchard is the elder vice president for subject argumentation astatine the Personalized Medicine Coalition. Susanne Munksted is the main precision medicine serviceman of Diaceutics, which provides pharmaceutical companies with solutions to enactment the motorboat of precision medicine diagnostics.
English (US)