Dana-Farber Cancer Institute, EGFR – Precision Medicine: Identifying and attacking genetic flaws

The Magic Pill

How Precision Medicine Can Change Everything

June 9, 2017, Bruno Jacobsen

When in 2015 then US President Barack Obama launched the US Precision Medicine Initiative, it seemed like a big acknowledgement by the government of the potential of precision medicine. Last year, the Chinese government showed they are keen on becoming the world leader in genomics when they announced their own China Precision Medicine Initiative project, which is to last for 15 years. While the US committed US$215 million for research and development, China has put aside US$9.2 billion for the project. But why are governments investing so much in this field? Why are genomics companies like Illumina or Agilent Technologies, who many of us have never heard of, worth billions more than Snap, Inc or Twitter?

Here is how precision medicine (PM) has the potential to change the world.

The ability to predict conditions and diseases

In the future, thanks to PM, doctors will be able to look into our entire genome and pick out mutations that sit in specific genes in our cells. In other words, they will be able to see whether we are at risk of developing all sorts of diseases and prescribe behaviours or medication that can help us fight off these diseases before they occur.

Some of this is already available today, but it is not cheap. Sergey Brin, Google co-founder, has had his genome mapped and found that inside his cells, in the gene LRRK2, there is a genetic mutation that is associated with higher rates of Parkinson’s. That has had a big impact on his life, and he now engages in many behaviours that are designed to significantly reduce his chances of developing the condition later on, like drinking green tea daily, swimming, and following a good diet.

According to him, this is likely to cut his risk of developing the disease in half, and he hopes that with the advances in neuroscience he will be able to reduce it even further.

Diagnosing and treating

But while precision medicine’s predictive powers are impressive, using it to diagnose and treat diseases is just as fascinating.

With PM, doctors do not just look for common symptoms and prescribe generic treatments that are applicable across a large number of people. Instead, by being able to precisely identify what type of mutation is causing a certain cancer and by looking at all the information about the patient’s health history, lifestyle, environment, and genomic data, doctors will be able to prescribe much more effective and targetted treatments.

This will result in much higher chances of survival for many of the scariest conditions because the treatment is tailored to a specific individual, not the general population.

Gene Editing

And some are betting that PM can reach even higher heights. With the recently developed CRISPR/Cas9 gene-editing technology, still in its infant stage, scientists can alter and edit specific DNA sequences, thus changing a variety of genetic traits.

Editas, a startup focusing on gene-editing technology, has just stricken a deal with Allergan for a partnership and will receive US$ 90 million in advance to develop gene-editing-based eye treatments. They had already announced their intent to carry on tests last year. They expect to inject a virus carrying Cas9 into the eyes of people who suffer from a type of progressive blindness. The virus will then cut out the faulty sequence causing the disease and, once that sequence is removed, the patients’ DNA will then start to heal their bodies and reverse the damage.

If this technology sounds almost magical, it is not. And we might be less than a decade away until it can cure a myriad of diseases. As Jim Flynn —manager of a US$5 billion healthcare investment fund—said, in a decade we will look back and realize there is an era “before gene editing and after.”

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