By Adebanke Fagbemi
There is an ever-increasing shift towards personalized medicine in the fields of medicine and biotech. This is no surprise because, although it has long been known that individuals respond differently to drugs or treatment, it has only more recently come to light that subtle differences in our genetic make up may be responsible. The idea that our genetic profiles could be used to predict not just our susceptibility to disease, but also our response to treatment, holds obvious enticement to the biotech and healthcare industry. This is evident in two recent news stories. First, it recently came to light that the drug Erbitux® which is used to treat colo-rectal, head and neck cancers, is uneffective in colon cancer patients with mutations in the KRAS gene. As a result, the two companies that market Erbitux® (ImClone and Bristol-Myers Squibb), re-labeled it to discourage patients with these mutations from using it. The idea being to hopefully protect such patients from long, expensive, unnecessary treatments, and unpleasant side effects associated with treatment. It would also, truth be told, protect the companies from potential lawsuits that could result.
In a slightly different, though equally important vein, a New England Journal of Medicine article published in the July 9 issue, reports the results of a clinical trial showing that the new PARP inhibitor Olaparib, is effective in treating breast, ovarian, and prostate cancers in patients with mutations in BRCA1 and BRCA2 genes. This is an important finding, as this drug elicits significantly milder side effects than conventional chemotherapy, and its side effects were easily reversed by lowering dosage, as shown in the study. With the human genome sequenced, information from genetic profiles of individuals will ultimately aid healthcare professionals in patient treatment, allowing doctors to better prescribe drugs, and dose accordingly. The information provided on susceptibility to diseases such as cancer will allow patients along with their healthcare professionals to monitor disease status, and when possible, maybe even prevent it.
When discussing this issue, however, there is the other side of the story. Once all this genetic information becomes available and easily accessible, what are the disadvantages? I can think of a major one – health insurance. With all the recent talk of health insurance and health care, imagine what would happen if the insurance companies were to get a hold of genetic profiles of potential customers. This would provide them with good reasons for refusing coverage to patients with certain susceptibilities. Forget “pre-existing conditions” when “potential conditions” come into play! Any and everyone could become a victim.
All in all, there is a lot to be gained from personalized medicine, as long as genetic information is handled with care. If drugs and treatment are like the saying “one man’s meat is another man’s poison”, then isn’t it essential that doctors be provided information to prevent them from treating patient A with a drug that, although effective in patient B, could be deleterious to patient A? Maybe my genetic profile could finally explain why Nyquil® keeps me wide awake at night, leaving me drowsy and groggy all of the next day, even though it’s marketed as giving you “the best sleep you ever got with a cold medicine”!