Obama’s precision medicine initiative – insufficient and off target?   Leave a comment

Two weeks ago, Barack Obama presented a “precision medicine initiative”. But is what the money go to really “precision medicine”?

It seems that a major sum, $130 million, will go to the NIH to develop a database of 1 million individuals with genomic data and hospital records. That is $130 per included individual. How can that be even a remotely sufficient investment, as genome sequencing is $1000 per person?

$70 million will go to the National Cancer Institute (NCI) to scale up efforts to identify genomic drivers in cancer, supporting novel more personalized medicines. Now, that is obviously a “precision medicine” initiative, as more effective and hopefully less toxic medicines will be developed.

$15 million will go to database searchability and protection of personal data. Nothing to be said about that…

In summary, I have mixed feelings about this initiative. Specifically, I am skeptical that sequencing a million genomes will help the development of precision medication. Understanding the diversity in the genome may be an interesting question in its own right, but the last twenty years of genome research has shown that very few diseases are directly connected to specific sequences or “single-nucleotide polymorphisms” in our DNA.

To develop novel precision medicines we rather need to understand the diversity of specific diseases, including asthma, cancer, diabetes, cardiovascular diseases, neurological diseases and inflammatory diseases, which scientists today call “disease phenotypes” or “endotypes”. By understanding molecular mechanisms involved in subgroups of disease, more personalized and efficient precision medications can be developed for future generations. Genetics will not be the answer, but more comprehensive and translational approaches are necessary, first describing molecular mechanisms of subgroups of disease, thereafter developing treatments targeting those specific mechanisms. That would be a true precision medicine investment.

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Posted February 15, 2015 by Jan Lötvall in Uncategorized

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