It is here but evolving slower than what all of us might like to see, and in many areas it is still so much of a “Science” but as developments occur through biotech we are seeing some amazing results. There’s also the bridging of the gap with bringing genomics to the point of care, as physicians and patients alike are still in the dark on the topic. R and D costs are high and much of it has been or is going to be outsourced outside of the US, and the treatment plans are not affordable in many areas.
Personalized medicine will continue to grow with breakthroughs and the challenge is to educate, bring to the point of care, and hopefully make the treatment plans affordable and covered by insurance plans. The FDA today is also working on gathering needed information to hopefully approve and get viable products to the market place, but in the war on cancer, it is simply something that can’t be overlooked and technology breakthroughs and studies appear every day on how information is helping to create a world of medicine that can be customized to work for the individual, not the masses, in a way that will help remove the trial and error processes as time goes on. It will take a joint effort from many entities to make this work. BD
The one thing Kevin Carlberg refused to face after his diagnosis with brain cancer in 2002 was anyone's estimate for how long he might live. His doctors and his family all knew the number: six to 18 months. "I understand the averages," says Carlberg, a rock musician who had just released a CD and was two months from his wedding date when he was told he had the worst stage of the worst kind of brain cancer, glioblastoma. "But every person is different." Those words could serve as a new mantra in medicine. After having his tumor removed and undergoing chemotherapy and radiation, Carlberg received a novel treatment that was designed using his own white blood cells and proteins taken from his tumor to prod his immune system into recognizing and attacking more cancer. It's an example of a growing health-care strategy known as personalized medicine.
Personalized medicine aims to minimize that one-size-fits-all model by matching each patient to a specific treatment based on the genetic and molecular characteristics of that person's tumor. Doctors can use genetic information gleaned from the tumor itself to choose — or avoid — certain medications for that patient or, as in Carlberg's case, create a treatment specifically for that person.
To identify these sub-types of cancer, doctors search for biomarkers, molecular indicators of how that tumor will respond to various drugs. Slamon, for example, worked for more than a decade trying to understand a protein biomarker called HER2.
Nonetheless, after a slow start, the field of personalized medicine is gathering steam as researchers and drug companies focus more on drugs to target subsets of patients instead of blockbuster medications aimed at treating all of them. According to the research company Datamonitor, sales of targeted cancer therapies grew 33 percent worldwide last year. Since 2005, 10 targeted drugs have come on the market.
Slamon spent years trying to persuade others that targeting HER2 would cure some women of breast cancer. Eventually, the drug company Genentech developed Herceptin.
"Drug development is becoming more complex and more challenging as we understand more," Slamon says. "But that is how it has to be if we're going to treat cancer more effectively."