Whether navigating the latest information about the health effects of certain foods or the benefits of specific medical treatments, the headlines and literature appear rife with examples of where what works for one person might not work for another. These seemingly conflicting findings can be the result of differences in just a handful of genes. While challenging, these individual differences also present an opportunity, a new way to treat patients with so-called precision, or personalized, medicine. Researchers are innovating new ways to make this approach more widely available—with, for example, new diagnostics for opioid disorders as well as new ways of scaling up precision medicine within the healthcare system.
As described in the ABE Exploring Precision Medicine curriculum module, doctors have long aimed to personalize how they prescribe medicines by modifying dosage or changing medications, largely based on trial and error. Since the Human Genome Project in 2003, however, scientists and physicians have had a new tool at their disposal—using DNA sequencing to test individual patients for certain traits and then tailoring medical treatments as needed.
Some of the greatest advancements in this personalized approach have come with cancer treatments, in which individual patients are tested for particular genetic markers that could make specific chemotherapies more or less effective for them as well as informing their overall risk factors. The scope of precision medicine continues to expand rapidly, including in new areas, such as making decisions about opioid prescriptions.
At the end of 2023, the FDA approved a genetic test for identifying individuals who may have an increased risk of developing opioid use disorder (OUD), the chronic use and dependence on opioids that affects more than 16 million people globally. Now, with a simple swab of the cheek to collect a DNA sample, healthcare professionals can test if a patient has genetic variants that put them at risk for OUD to help inform whether and how to prescribe an opioid for pain management.
Such tests open a window into a future where such diagnostics can make more widely available medical treatments based on individual differences. A major challenge for precision medicine is finding a way to offer individual treatments on a large scale in a cost-effective way.
In a recent study published in Frontiers in Medicine, researchers use a new data science–driven model to help healthcare professionals identify patients who would benefit the most from personalized medicine. The case study for their model was bladder cancer, which is a condition known to produce widely varying responses in treatment, with some patients, for example, not responding effectively to immunotherapy post-surgery. The researchers hope that their model will enable precision medicine to become more economically viable and widely available.
ABE teachers and students can explore more of the potential for precision medicine in a new module, whose release was delayed by the COVID-19 pandemic. Now that swabbing students’ cheeks is possible again, ABE sites are rolling out the new module to explore individual genetic differences and how they might manifest in health settings.
“These differences can have some pretty clear ramifications when you are talking about treating medical conditions—such as whether your body metabolizes a medication or not, or whether or not your body will respond to medication or is super sensitive to a medication,” said Maia Binding, who leads ABE San Francisco Bay Area, in an interview last year. The module is thus a powerful way to connect these new advancements in science and medicine to students’ everyday lives.
View a video created by ABE Italy students about their experience with the ABE Exploring Precision Medicine module.