Precision medicine: Uses and challenges

Abstract

Precision medicine has brought in many changes to the practise of medicine. The omics-based development of biomarkers and pharmaco-omics-based drug development programmes are evidences for the advancement. However, the field where it has proved to be most useful is in the development of various modalities of treatment in oncology. Various drugs targeting vascular endothelial growth factor, epidermal growth factor, tyrosine kinase receptor and rat sarcoma mutations have come to the forefront proving to be beneficial in many cancers. Some of the classic drugs developed using this concept include trastuzumab, bevacizumab, cetuximab and panitumumab among others. Precision medicine has been put to best use in the COVID-19 pandemic through use of various biomarkers such as IL-6 and c-reactive protein in assessing severity of disease, for development of various therapies and also to judge efficacy of vaccines. Precision medicine is also finding its place in management of infectious diseases, chronic diseases such as asthma, connective tissue diseases, cardiovascular diseases, diabetes and obesity. India has also made its presence felt in the field by launching various initiatives such as the Indian genome project and Indian cancer genome atlas. Numerous challenges still exist to the future of precision medicine such as cost involved, ethics, security of the Big data, merger of various platforms to integrate data and also availability of trained manpower to manage the data and algorithms. This new age medicine is a big step forward for mankind and hopefully it will bring more benefits for both patients and the caregivers in the near future.

Keywords: Challenges; Emergency Medicine; Oncology; Precision medicine.

Fig. 1

The various anti-Her-2 therapies in clinical use and research. Shown are the monoclonal antibodies (A), tyrosine kinase inhibitors (B), antibody-drug conjugates (C) and other drugs such as Bi-specific monoclonal antibodies and so on (D). TCR, T-cell receptor 9.

Fig. 2

Time-line of development and approvals for use of various small molecules (tyrosine kinase inhibitors) for various malignancies. NMPA, National Medical Products Administration (China); MHLW, Ministry of Health, Labour and Welfare (Japan); FDA, Food and Drug Administration (USA).

Fig. 3

Figure depicting the process of CAR-T cell therapy. CAR, chimeric antigen receptor. CRISPR- Clustered Regularly Interspaced Short Palindromic Repeats; cas9- CRISPR associated protein9.

Fig. 4

Precision medicine in asthma.