Smoothing the way for personalised medicines

Before personalised medicine, most patients with a given disease received the same treatment, even though many didn’t respond. Today, greater knowledge of genetics and genetic susceptibility has enabled the targeting of treatment plans to each patient’s needs, particularly in cancer. Targeted therapy is directed at a cancer’s specific genes, proteins or micro-environment that are known to contribute to its growth and survival. Examples of classes of targeted drugs include hormone therapies, gene-expression modulators, signal transduction inhibitors, angiogenesis inhibitors, immunotherapies and apoptosis inducers.

We’ve made progress in developing more effective, targeted treatments and determining subpopulations of responders, but more work is required

At the same time, pharmacogenomics has the potential to reveal whether a targeted therapy is likely to work in a particular patient by looking at how the person’s genes affect the way the body processes and responds to a specific drug; this, in turn, influences drug safety, efficacy and dosing for that individual. Breast, kidney, lung and colorectal cancer are among the cancers for which targeted treatments are available for the right patients. Targeted therapy also is becoming available for other conditions, such as rheumatoid arthritis and certain forms of diabetes – and many more targeted options are needed.

However, targeted therapies are not without some downsides, as they may cause side-effects or stop working altogether (e.g. a tumour becomes resistant to therapy); genetic testing of both the patient and, in the case of cancer, the tumour, can be complex and costly. The treatment itself can, on average, reach upwards of US$1,000 a month.¹ In short, we’ve made progress in developing more effective, targeted treatments and determining subpopulations of responders, but more work is required.