The future of precision medicine part 1: challenges and opportunities
The promise of precision medicine has been extolled by researchers and clinicians for some time, but as sequencing costs continue to fall, sophistication of data analysis and patient stratification increases and data science and artificial intelligence (AI) begin to partner with the life sciences industry in earnest, that promise now seems closer than ever to realisation.
The prospect of individualised, truly science-based treatments backed up by a deeper understanding of the particular genetic, social and microbiological identity and environmental circumstances of the patient and/or their disease is simply too exciting to ignore.
Consumers have also embraced the genetic revolution, with direct-to-consumer genetic ancestry test kits reaching unprecedented levels of popularity over the last year, even to the point of becoming some of the top-selling products in the Black Friday and Christmas sales period in the US.
According to MIT Tech Review, more people took genetic ancestry tests last year than in all previous years combined. The number of people who had their DNA analysed via direct-to-consumer kits more than doubled in 2017, now exceeding 12 million.
Consumer genetics company 23andMe has recently received approval for its direct-to-consumer “ancestry and health” test to report on three mutations in the BRCA1 and BRCA2 genes associated with breast cancer.
In the context of spiralling healthcare costs, chronic underfunding and lack of access to health services, an increasingly aged global (and particularly first world) population, and the continuing rise of lifestyle-related disease, the healthcare industry and governments around the world are turning to precision medicine as an opportunity and a potential saviour.
This is the first in a series of articles intended to be a wide-ranging discussion of the opportunities and challenges that clinical and research communities, and the public at large, will face in translating the promise of precision medicine into real world clinical practice and improved outcomes for patients.
The discussion draws on a wide range of sources and views, and in particular incorporates and comments on insights from recent expert forums on the topic, which include a Westminster Health Forum (WHF) keynote seminar and a panel session at the World Economic Forum (WEF).
This first article will provide an overview of some of the high-profile precision medicine initiatives being spearheaded in the US and the UK, briefly recap developments in 2017 and offer a snapshot of the capabilities and limitations of precision medicine.
Later instalments in the series will focus on particular technologies, and the opportunities or challenges that will need to be addressed by the field at a global and/or local level, including:
