PERSPECTIVES FROM THE MEDICAL WRITING TEAM

March 29 2017 Tahmeena Chowdhury, PhD

“The Cancer Lottery” in MIT Technology Review (January/February 2017) provides an excellent overview of precision medicine in treating cancer by following the journey of an artist living with cancer for over 30 years.  I find the linear approach, where we can hone in on a specific root cause of an event on an individual basis and then go “fix” it, very appealing; and hence, I was looking forward to learning more about precision medicine in a real world setting.

Developing drugs that target key specific mutations in diseases offers a simple and intuitive treatment approach.  The caveat, however, lies in taking a simplistic view of intricate disease mechanisms.  Despite demonstrating promising results in oncology, as evidenced by the blockbuster drugs Herceptin, Gleevec, and Zelboraf, precision medicine has mostly been ineffective due to the complexity of diseases.

Even in the absence of an existing drug targeting a mutation, the availability of tumor DNA data in an accessible database allows researchers to identify potential subjects for studies testing novel, experimental drugs.  Despite such promising results, precision medicine faces considerable challenges to its value as an effective and practical therapeutic approach.  Many patients do not respond to this therapy, with short-lived positive effects in the subset that do respond.  One researcher even refers to successes in precision medicine as winning the lottery.  Moreover, tumor DNA sequencing and treatment with targeted drugs remain expensive, and insurance companies do not always cover these costs.  Proponents argue, however, that even if a small percentage of patients benefit, that should be sufficient reason to pursue this approach.  As more and more data become available, they hope to increase the number of patients who respond to treatment.

The article is a fascinating read about the emerging therapeutic approach of precision medicine.  As clinical developments in the field progress, it will be interesting to see how the debate amongst researchers continues to develop and hear the thoughts of other stakeholders.  While it was fascinating to learn about developments in this emerging technology, the most thought-provoking part of the article, for me, was the discussion addressing the question:  “Is it worth it?”

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