By: Michelle Savoie, Howard Bergman, Daniel Denis, Patrice Hugo, and Nathalie Ouimet
THE ARRIVAL OF PERSONALIZED HEALTHCARE IS INEVITABLE
Personalized Medicine
Article translated by Pamela Lipson
The question is, are we up to the challenge? The developments and discoveries in disciplines such as genomics, proteomics, imagery, Information Technology and Communications (ICT) and community health ensure that we can now expect to reach the goal set by Hippocrates to determine preventive and treatment approaches for the right person at the right time.
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or many, personalized healthcare (PHC) represents a revolutionary approach that will fundamentally change the ways in which health, disease and the medical practice are managed.6 Personalized medicine – more specifically, PHC – constitutes a tailored response to the healthcare challenges of the 21st century and especially to chronic disease, which is the leading cause of morbidity and mortality in modern societies and generates the most demands on the healthcare system. PHC fuels the hope of improving individual and community health of individuals and of better controling the rising healthcare costs. PHC tools more accurately stratify the different sub-types of illnesses, thereby ensuring that only the patients who will benefit from a therapy will be treated. For example,
HerceptinTM (TrastuzumabTM) cannot be used to treat all patients suffering from breast cancer because only 20-30 per cent of them can benefit from treatment.7 However, there exists a PHC tool/diagnostic test to identify women whose tumours exhibit the protein HER2, the target of HerceptinTM, and which are therefore able to benefit from the HerceptinTM treatment. This diagnostic test, used in conjunction with the drug Herceptin,TM increases the response rate to close to 80 per cent.8 As a result, the use of PHC enables patients to not only avoid adverse side effects, but also helps optimize the therapeutic use and achieve substantial savings because, depending on the therapeutics, between 20 per cent and 70 per cent of patients fully benefit from the therapies that are implemented. PHC has the potential to not only better target treatments and lower the proportion of
patients who could suffer from side effects, but also helps to adjust the treatment dosage and identify the types of patients most at risk for developing an illness (targeting patients who could benefit from preventive treatment). By stratifying the healthcare services being offered, PHC therefore has the potential to radically change the practice of medicine and transform the role of the individual with respect to his own health and that of the organization of the healthcare system. Nevertheless, the hope fueled by PHC should not give the impression that a quick change or highly short-term results are on the agenda. Rising to these challenges is more analogous to a marathon than to a sprint, but it’s a marathon in which Québec must enter because the arrival of PHC is inevitable. The development of PHC involves issues and challenges that Québec cannot avoid: technological, socioeconomic, industrial, as well as those challenges related to research financing, regulatory approval, intellectual property, training of those involved and management of the healthcare system. Major changes in the health sector and in industries in this sector are in fact necessary NOVEMBER 2011 BIOTECHNOLOGY FOCUS 11
