The state of personalised medicine in 2019

Things are good, and they’re getting better.

When researchers completed mapping the human genome in 2003, it broke new ground for what was medically possible. This work specifically involved determining the order of the four chemical building blocks that make up a DNA molecule, called “bases,” and every person has approximately 3 billion pairs of them. The order in which these bases appear reveals the genetic information that each segment of DNA carries, and for the first time, scientists were able to interpret what they meant.

Personalised medicine leverages this breakthrough to offer customized, high-quality medical care to patients on an individualised basis. The “secret sauce” is in tapping the patient’s genetic makeup to learn fundamental details about who they are — things the patients might not even know about themselves. Do they have a genetic predisposition to certain health conditions? Do they have an obscure gene mutation that provides essential guidance on how to treat a medical problem?

Bundled with the conventional rundown on a patient’s age, gender, medical history, and family medical history, this vital information opens up a brave new world for medicine. We’re living in it today, but that doesn’t mean we’ve eradicated disease. There’s still lots of good work to be done in bringing personalised medicine to the forefront of healthcare, but this future gets a little brighter every day.

Here’s what you need to know about the state of personalised medicine in 2019.

We’re not exactly close to curing cancer, but we’re close to making it chronic

In other words, we’re on our way to making cancer more like asthma: it won’t necessarily kill you, but a patient might have to deal with it all his or her life. This is a significant improvement from the way things are now: almost two million people were diagnosed with cancer last year, and more than half a million people died from it.

Importantly, the general medical view is that researchers simply aren’t going to cure cancer. It’s not just one disease, but a family of diseases, each one unique from the others. That’s why personalised medicine is a powerful attack vector for taming these conditions. By considering the individual first, its methodology makes cancers less lethal and more manageable.

The placebo effect might play a small role

Let’s be clear: personalised medicine is no placebo. It works in hard medical terms to fight disease. But patients enjoy a certain psychological satisfaction in knowing that they’re getting a bespoke treatment that’s designed just for them from the ground up.

It’s the same reason you might feel especially confident and good-looking while wearing a custom-tailored suit or dress. It’s not a mass-produced clothing item that you might see a stranger also wearing on the street. You know that this garment is completely unique to you, designed by experienced professionals to flatter every part of your body. Who wouldn’t want that, and who wouldn’t feel an instant mood boost while wearing it?

I think it’s highly compelling to understand what each patient wants and to understand what’s actually going to improve their quality of life. Giving them a powerful course of treatment designed especially for them is only going to make them feel good about taking it.

Personalised medicine is not necessarily about extending a patient’s life, but it can greatly enhance their quality of life

Cancer tumors might grow to the point that they add pressure to a vital nerve or obstruct some essential internal process. This is why people might go blind or lose the ability to walk while dealing with an unrelated illness. There’s very little good news to be had when health problems compound like this.

But personalised medicine grants us access to a fuller picture of what’s going on with an individual patient. Customised treatments that account for all the fine details, down to the patient’s own genetic makeup, are vastly more effective than any off-the-shelf cookie cutter approach. Personalised medicine enables the development of treatments that can shrink (or completely eradicate) those problematic tumors to the point that the patient regains independence and sees an improved quality of life.

As mentioned, we’re not in a position to cure cancer yet, but we’re able to fight it very well. We’ve seen patients ride bikes and play with family members again after their medical condition took those things away from them

It’s not especially affordable yet

The price of this specialised treatment is a real barrier to people to many people. As someone who operates a personalised medicine company, it doesn't feel good to hear that there are highly interested patients who can’t afford it. It also doesn’t feel good to know we can’t give this treatment away to people who need it for free. There are foundations out there that bridge financial gaps for patients in need, but the best version of personalised medicine is one in which it’s accessible and effective at the same time.

This financial component will surely improve in the future. Though we might not see it yet, new technologies and methodologies will inevitably emerge to deliver the same results at a reduced price. If there’s any major challenge to operating a business in this space in 2019, it’s surely the cost.

That’s why we occasionally talk about operating at a loss: it’s really important to get patients in the door, because their aggregated data is what makes personalised medicine so effective. It’s probably worth losing a little bit of money up front to get valuable traction from patients.

While the future of personalised medicine is distinctly exciting and bursting with promise, it’s important to acknowledge the good work that’s already going on in the field today.

Even though things are improving here every day, there’s still lots of good work left to be done.

About the author

Laura Towart is the founder and CEO of My Personal Therapeutics, a London based digital health company offering personalised cancer therapeutics.  She is also the founder and former CEO of Celmatix, a leader in diagnostics and predictive analytics for female infertility and women’s health. Laura is a graduate of the Weill Cornell Graduate School of Medical Sciences and Memorial Sloan Kettering Cancer Center’s Doctoral program and received a Certificate in Bioinformatics.  Laura holds a BS/BA in Biology/English from The George Washington University.