Posted by: tristar3research | April 20, 2009

The Promise of Personalized Medicine- Hype or Hope?

The Economist asks: In the decade since the Human Genome Project reported preliminary results in 2000, the promised benefits of genome-inspired drugs and more individualised health care have failed to materialise. Could personalised medicine now be closer at hand? Some academics remain deeply sceptical. Allan Balmain of the University of California, San Francisco questions the scientific basis for the claims made by such firms. David Altshuler of the Broad Institute, a genetics-research centre run jointly by Harvard and MIT, thinks the firms encourage people to read too much into their results. Such “fallacies”, he says, are causing a public backlash that could divert attention and resources from the worthier goal of genomics-inspired disease research.

Personalized medicine early adopters: cancer, HIV

Personalized medicine early adopters: cancer, HIV

Of course, there is only a small percentage of the person’s DNA analyzed by even the more advanced labs. The firms analyse only a tiny part of a customer’s DNA. In particular, they look at certain parts of a chromosome known as single-nucleotide polymorphisms (SNPs, pronounced “snips”). They argue that variations in SNPs are correlated with the likelihood of developing a range of nasty diseases. Researchers are now trying to find out to what extent the efficacy and safety of many new drugs is influenced by genetic factors. It is surprising, therefore, that the ailing drugs industry seems indifferent to genomics, except in cancer research. Dr Venter believes the reason is economic: “Genomics is totally changing the basis of medical research, but Big Pharma was better off when we knew less.”

A promising genomics cost curve

A promising genomics cost curve

What’s promising is “The new Moore’s Law” which is actually much more promising than the progressive halving of the imbedded cost of processors in 1980-2000. Sequencing equipment has been improving even faster than microprocessor performance, which doubles roughly every 18 months for the same outlay under a rule dubbed Moore’s law. The newer sequencing machines borrow ideas from silicon-chip manufacturing. One consumer-genomics firm called Knome (pronounced “know-me”) uses nimble machines that deposit millions of tiny dots filled with DNA snippets on a flat surface, typically glass. The DNA in these dots can be “read” by molecular machines to signal the presence of different DNA variants. This process has brought down prices by a factor of ten every year since its introduction in 2005. The next sequencing technologies promise to read whole genomes quickly and at a reasonable cost, and several rival firms are already racing to get them to market. When they do, it will have a profound impact on the economics of health care.



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