precision medicine (PM)

History of precision medicine

Precision medicine emerged over the last decade in concert with advances in genetic research and genomics, especially DNA sequencing -- exemplified by the Human Genome Project. It has also progressed rapidly with the growth of data analytics and cognitive computing in the health information technology sector. 

Precision medicine's most common current uses are for cancer and diabetes treatments. It is also being used in cardiology and neurology, and with conditions related to aging and patients with rare illnesses.

Precision Medicine Initiative

Precision medicine got a big boost in research and awareness when President Barack Obama unveiled the Precision Medicine Initiative (PMI) in his State of the Union address on Jan. 20, 2015. Also bringing attention to precision medicine is the All of Us Research Program -- formerly called the Precision Medicine Initiative Cohort Program.

With $130 million in funding from the National Institutes of Health, the research program aims to gather data from at least 1 million Americans from diverse backgrounds to accelerate progress toward individualized medical treatments. Treatments have previously been designed with a one-size-fits-all approach, which works well for some patients, but not others.

The All of Us program seeks to use data from diverse populations, since breakthroughs in medicine have traditionally been based on findings from a limited portion of the population. Researchers in the program will record volunteers' health metrics, collect blood samples and follow their health over time.

The PMI also provided $70 million in funding to The National Cancer Institute for a cancer genomics project associated with precision medicine. The bipartisan 21^st Century Cures Act also provides funding for precision medicine research.

Precision medicine vs. personalized medicine

Although the terms are sometimes used interchangeably and share similarities, there are differences between personalized medicine and precision medicine.

Experts argue that personalized medicine is akin to basic patient care -- that is, healthcare providers make decisions about treatments based on what the patient needs or prefers, which makes the treatment personalized. As such, agencies like the Centers for Disease Control and Prevention argue that medicine is already supposed to be personalized.

Precision medicine, on the other hand, describes medical therapies that are determined by analyzing specific subgroups of patients using factors such as genetics, lifestyle and environment.

Precision medicine benefits

One of the major benefits of precision medicine is that it uses a comprehensive profile of the patient to determine an appropriate treatment. This includes not just genetics, but family history, diet, exercise, stress level and more. These factors enable a healthcare provider to develop an effective treatment plan that is not based on the average patient, but the individual patient, instead.

By taking this approach, caregivers hope to increase the chances of patients surviving diseases such as cancer, which has dozens of variations.

The future of precision medicine

There are several advances in precision medicine that will shape its future, including new and expanded treatments for certain conditions.

Since 2014, the Center for Drug Evaluation and Research, part of the Food and Drug Administration (FDA), has approved more than 25 new drugs that target specific genetic traits in patients. The dosing for these medications can be tailored to the individual patient. The agency has also approved new uses for drugs that were already available, and said advancements in the use and development of biomarkers -- such as the size of a tumor -- will help develop more targeted therapies for precision medicine.

In May 2017, the FDA expanded the approved use for a drug that treats cystic fibrosis. The approval raised the number of gene mutations that can be treated from 10 to 33, based on new data about genetic mutations. That same month, the FDA also approved the first treatment for patients whose cancer has a specific genetic feature.