Personalized medicine, the gateway to a diseaseless future

In his 2010 TED Talk Watch Me Unveil Synthetic Life, Dr. Craig Venter¹ laid out a new vision for human medicine when he described how,

“The cells in our body are like computer hardware, and our genetic code is the software that controls it”.

Venter’s novel idea hinted at his hope for a reformation in the philosophy of mainstream medical treatment. Instead of diagnosing the malfunction and symptoms of the body to treat disease, Venter’s talk suggested a bottom up approach to medical care by understanding the underlying faults that can occur in human genetics, and prescribing individual treatment based on these findings. For the healthcare community, Venter’s view gave a much needed push for a rising new medical philosophy called personalized genetic medicine.

Personalized medicine retires the idiom of “one-size-fits-all” healthcare by sequencing a patient’s genes in order to cater treatment to their specific needs [2]. The rapid growth of this new healthcare philosophy is the consequence of macro-level forces pushing it into the public eye. In fact, there are four research, economic, opportunity, and technology related reasons why genetics-based healthcare and personalized medicine will become the dominant form of treatment in the decade to come.

A Tale of Two Pharma's

One of the largest influencers in personalized healthcare’s rise is the significant research to back its effectiveness. Recent studies on drug resistance in cancer patients illustrate how genetics-based medicine is becoming a necessity for disease treatment. In 1992, pharmaceutical company Novartis developed Gleevec by sequencing leukemia patient genomes and successfully repairing a dysfunctional protein in their body [4,5]. However, between the 1992 release and 2010, a growing number of patients were developing resistance to the drug [6]. As a result, competitor ARIAD Pharmaceuticals performed their own genetic sequencing tests on resistant patient’s genomes to discover a second genetic mutation preventing Gleevec from functioning. With this knowledge, ARIAD launched clinic trials of a new drug called Iclusig to correct the deficiency caused by the resistance patient’s genetics and in the process save thousands of Gleevec resistant patients [7]. The critical role played by a personalized genetic approach rather than a traditional one in these cases cannot be understated. Had these pharmaceutical companies chose a traditional symptomatic approach to drug development rather than a genetic root cause one, many mothers, fathers, family members, and friends would likely not have lived past their anniversary diagnosis. Taken together, the large improvement in patient lifespans as well as of the growing number of successful genetically developed drugs, are indications that the future of medicine will require a more individual attitude to treating patients.

Rapid Declines in Genetic Sequencing Costs

Although the research signals for personalized medicine are strong, the economic forces involved in its popularization are growing as well. The rapidly declining costs in genetic sequencing are making personalized and genetics-based treatments more accessible and practical to the public. Researchers like Elaine Mardis have observed with convincing evidence that,

“The decade since the Human Genome Project ended has witnessed a remarkable sequencing technology explosion… at unprecedented speed and resolution.”. [8]

In fact, based on forecasts by, between 2007 and 2010 sequencing costs dropped almost five-hundred-fold compared to predictions by Moore’s law [9]. Predictions of the price per genome in USD by Moore’s law in comparison to the actual reduction in whole genome sequencing costs recorded to date. This drop has resulted in today’s price of just under one-thousand dollars per genome, which when contrasted with the predicted data set, is convincing evidence that the economics of genetic sequencing are becoming much more practical.

From the lens of personalized medicine, the rapid decline in costs provides two incentives: greater public affordability and worthwhile profits for sequencing based businesses. Low-cost genomes provide budget-strained healthcare professionals the opportunity to explore personal genetic treatment, while viable economics opens the door to genetic testing for the masses. Altogether, it is difficult to discount the intense economic forces in favour of personalized medicine.

Biotech Funding Booming

As a consequence of both the economics and intense research forces, the personalized genetic healthcare philosophy is gaining interest from investors, governments, and venture capitalists. The positive support for genomics and medical research developing across the world is creating serious access to capital and opportunity to create new businesses based on genetic healthcare. China’s economy has seen a tripling in research and development investment, with over one billion dollars committed to research hubs such as Beijing Genomics Institute [10, 11, 12] Accordingly, U.S. venture capital for biotechnology has risen yearly since 2010, hitting a record high of almost nine-billion dollars in 2015 [13].

Total financing and venture capital investments made by United States investors in up-start companies in the Biotechnology sector from 1996 to 2015. [13] This global wave of opportunity and capital for entrepreneurs to build genetics-based healthcare companies creates additional awareness and resources for patients and doctors to use a personalized medical approach. With the level of impact venture-backed companies such as Google and Microsoft have made in the past, it is difficult to deny the power of investor interest and opportunity in the case for personalized medicine.

The Technology, Life Science Alliance

Nonetheless, despite the favourable forces of science, economics and opportunity championing for genomic medicine, skeptics will point out the lack of innovation in the field of life sciences to harness the power of personalized medicine. This critic is considerable and brings to light a potential flaw in an argument for a future of personalized medicine. Although sequencing technology has become cheaper and faster, current life science researchers have not been able to develop tools to handle and analyze the data obtained from genomes efficiently. Nevertheless, this need has sprouted a new opening for collaboration and the final technological force for personalized medicine: the emerging alliance between technology companies and the field of life sciences.

Companies such as IBM, Microsoft and Google are beginning to leverage the muscle of their data centres and computing power to support genome analysis within the medical and research community [14,15]. What is more, the behemoth IBM is developing a cognitive computing system called Watson to assist health care practitioners in deciphering the millions of publications and genomes [16]. Because of this great collaboration, life science researchers will not need to invent new genome processing technology since the infrastructure is already in place, ready, and waiting to be used. With this, it is tough to imagine genomic medicine not thriving as it stands upon shoulders of giants who have created much of the abundance seen around the world today.

In a time where nothing is considered impossible, it is tall order to envision that the world’s attention to solving complex problems will not eventually shift to the challenge of conquering death and disease in our lifetime. The research, economics, opportunity, and technology are all lined up in a single direction towards bringing personalized and genomic medicine to the masses. With this, it is clear that as a species the human race is steering its way into a new era of solving life’s trickiest problems including illness and possibly mortality.

Although the original War on Cancer was declared in 1971 and so far disease has continued to win round-after-round of this medical boxing match, it is clear that the gloves are coming off as healthcare providers step into the second round with tools like personalized medicine. However, it is up to the citizens, governments and entrepreneurs of the world to begin educating themselves, putting their ideas into action and building out their dreams if we are to hope for a future without disease or illness. As the PayPal co-founder Peter Thiel and his co-author Blake Masters describe in their book Zero to One,

“[everyone] can find singular ways to create the new things that will make the future not just different, but better — to go from 0 to 1… we can both re-create [the world] and preserve it for the future… You are not a lottery ticket”. [18]
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References

[1] Venter, Craig. “Transcript of “watch me unveil ‘synthetic life.’” TED in the field: TED, 2010. Speech.

[2] McMullan, Dawn. “What Is Personalized Medicine?” Genome 2014: n.pag. Web. 16 July 2016.

[3] “Man Diagnoses His Own Chronic Pain by Sequencing His Genome.” Dir. Greg Merhar. CBC News. 16 May 2016. Audio.

[4] Verfaillie, Catherine et al. “Chronic Myelogenous Leukemia: Mechanisms Underlying Disease Progression.” Leukemia 16.8 (2002): 1402–1411. Electronic.

[5] Gambacorti, Carlo. “CML Patients Taking Imatinib Have Similar Mortality Rates to People in General Population.” Journal of the National Cancer Institute 103.7 (2011): n.pag. Electronic. 16 July 2016.

[6] Shah, Neil P., et al. “Multiple BCR-ABL Kinase Domain Mutations Confer Polyclonal Resistance to the Tyrosine Kinase Inhibitor Imatinib (STI571) in Chronic Phase and Blast Crisis Chronic Myeloid Leukemia.” Cancer Cell 2.2 (2002): 117–125. Web.

[7]Cantor, Maria. “ARIAD Announces Initiation of Ponatinib (AP24534) Pivotal Trial in Drug-Resistant or Intolerant Chronic Myeloid Leukemia.” Business Wire, 13 Sept. 2010. Electronic. 16 July 2016.

[8]Mardis, Elaine R. “A Decade’s Perspective on DNA Sequencing Technology.” Nature 470.7333 (2011): 198–203. Web

[9] Wetterstrand, Kris. “DNA Sequencing Costs: Data from NHGRI Genome Sequencing Program (GSP).” 2015. Electronic. 16 July 2016.

[10] Hudson, John, et al. “It’s Official: China Is Becoming a New Innovation Powerhouse.” Foreign Policy 7 Feb. 2014: n.pag. Electronic. 16 July 2016.

[11] Ross, Alec. The Industries of the Future. United States: Simon & Schuster, 2016. Print.

[12] Larson, Christina. “Inside China’s Genome Factory.” MIT Technology Review 19 Sept. 2014: n.pag. Electronic. 16 July 2016.

[13] Gormley, Brian. “Biotech Venture Investors Expect Slowdown Despite Record 2015.” New York: Wall Street Journal, 28 Jan. 2016. Electronic. 16 July 2016.

[14] “Google Genomics — store, process, explore and share.” Google. Google Developers, n.d. Electronic. 16 July 2016.

[15] “Empowering Health.” Microsoft.: Microsoft Corporation, 2015. Electronic. 16 July 2016.

[16] Royyuru, Ajay. et al. “Genomic Medicine.” IBM Research. IBM Corporation, 22 Mar. 2013. Electronic. 16 July 2016.f

[17] Moore, Gordon. “Cramming More Components onto Integrated Circuits.” Electronics 38.8 (1965): 114. Print.

[18] Thiel, Peter, and Blake Masters. Zero to One: Notes on Start Ups, or How to Build the Future. United Kingdom: Virgin Books, 2014. Print.

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