The future of healthcare is already here (2011)
Tailoring a person’s medical care to their genetic makeup may sound like science fiction, but “personalised medicine” is already here – as scientists and health professionals discussed at the annual Maurice Wilkins Centre Symposium in 2011.
Personalised medicine aims to deliver more effective therapies that do less harm. The greatest strides have been made in cancer medicine, making the field the natural focus for the symposium.
Clinicians speaking at the event agreed that we are in a major new era of cancer medicine. No longer do all patients with a particular cancer receive the same treatment. Every patient’s cancer has different characteristics, and by mapping those characteristics – in particular the genetic changes that make the cells cancerous – it is possible to select a treatment regime finely tailored to a patient’s tumour. New drugs that target specific genetic changes may be part of the regime.
Oncologist and clinical researcher Professor Peter Browett described how for many years it has been standard practice to select treatments for blood cancer based on DNA analysis (both chromosomal typing and DNA sequencing), resulting in dramatically improved responses to treatment.
Colleagues Professor Mark McKeage and Dr Mike McCrystal explained that personalisation is at an earlier stage for lung cancer, and for melanoma – for which the first targeted drugs are just becoming available – but even these notoriously difficult-to-treat malignancies are likely to follow suit. “I’m optimistic the advances being made in some cancers will eventually be reflected in others,” Mike said.
Tumour DNA analysis is not the only way to personalise treatment, however. For instance, Associate Professor Alistair Young explained that modern medical imaging provides a detailed picture inside the patient’s body before and during treatment, allowing a more tailored approach. Dr Nuala Helsby showed how a patient’s genetic profile determines the rate drugs clear from their bodies – by understanding the genes involved it is possible to adjust drug dosages to maximise effectiveness and reduce side effects.
A critical factor in the rise of personalised medicine has been dramatic improvement in the speed and affordability of DNA sequencing around the world. Scientists Dr Mik Black and Associate Professor Cris Print described how sequencing technology is now readily available in New Zealand and is being used in numerous clinically-focused research programmes, both to aid diagnosis and targeting of therapy, and reveal the genetic factors behind differences in disease susceptibility for different groups of New Zealanders.
“The Maurice Wilkins Centre has a strong focus on developing high technology solutions relevant to health,” says Director Professor Rod Dunbar.
“The clinical insight gained at the meeting should help health professionals and administrators envision the impact of this new technology on the healthcare system. Bringing the clinical and scientific communities together also helps our investigators plan how to develop the technology for maximum impact on the health of New Zealanders.”
Image: Dr Mike McCrystal speaks about developments in melanoma treatment at the Personalised Medicine Symposium. Photograph courtesy of Godfrey Boehnke.