Medical Science Liaisons in the Age of Personalized Medicine – Part 1
The idea is logical and straightforward: we are all created differently, and therefore, the best medicine and the most appropriate dose is likely to be unique for each of us.
Welcome to the idea, if not quite the age, of personalized medicine, where the goal is to treat every patient with the proper medication, in the appropriate dose, at the precise right time. This customized approach to medicine comes on the heels of the exact opposite, the era of the blockbuster drug - one drug designed to treat as many patients as possible, creating economies of scale for the manufacturer and a way to leverage the very long and expensive drug development process.
Though the roots of personalized medicine go back to the late 20th century, it is the 21st century that brought personalized medicine into focus. Innovations like reasonably cheap and fast DNA sequencing has allowed researchers to understand the minute variations between individuals better and relate DNA sequences with precise traits, e.g. how individuals differ in their reaction to medications.
An example is the effect of variations in the CYP2D6 gene – the gene that encodes the enzyme Cytochrome P450 2D6 - on drug metabolism. The CYP2D6 gene is involved in the metabolism of many commonly prescribed drugs, incl. tamoxifen, a drug used to treat breast cancer. More than 100 different variants (alleles) of this gene exist, many of which affect an individual's ability to ingest a drug and digest it safely. Based on the rate at which an individual metabolizes a drug, the dosage must be adjusted accordingly.
Personalized Medicine Means Data
Though we are still far away from achieving the ideal iteration of personalized medicine, one thing is clear: personalization involves the creation of vast amounts of data: specifically genetic data, clinical trial data, and the enormous trove of so-called "real-world data