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What Is Tailored Medicine?

Reviewed by Michael W. Smith, MD on January 11, 2021

Doctors have known for a long time that people don’t respond to medical treatments the same way. A new approach, called tailored medicine, allows experts to treat people with certain conditions using personalized plans.

Tailored medicine also may be called “precision medicine,” “personalized medicine,” and sometimes “genomic medicine.” It uses your genetic information, lifestyle, and environment to create (or tailor) a treatment plan for your illness. In some cases, tailored medicine leads to better results, especially for people with rare or advanced diseases.

Tailored medicine also can help doctors create personalized plans to prevent certain conditions.

The field is still in its early stages, but doctors already use it for:

  • Certain forms of cancer, including lung, breast, and colon cancers
  • Rare childhood illnesses
  • HIV and AIDS
  • Cystic fibrosis
  • Pharmacogenomics, or prescribing medication based on your genes

 

How Tailored Medicine Works

Uniquely You: Exploring Tailored MedicineHow does personalized cancer therapy engineer your immune system to fight tumors, and what’s in store for the future of these treatments?192

[MUSIC PLAYING]



MICHAEL POSTOW, MD: Tailored

medicine is really a type

of treatment

where we're trying to tailor

a treatment to match

a specific person

and that specific person's

tumor.



The whole idea

is that each person is unique.

Each person's tumor is unique.

Sometimes within one person,

different tumors will be

different from each other.



RAZELLE KURZROCK, MD: We've

actually taken to calling them

malignant snowflakes.

If you look at the structure

of snowflakes, each one

is unique, and each one

is complicated.



PHILIP GREENBERG, MD: It's

about what makes your tumor

your tumor.

How is that

different from somebody else's

tumor.

And what are the Achilles heel

of the tumor that you have

that we can go after.



DAVID MALONEY, MD, PHD: I think

there are many ways

of personalizing cancer therapy.

The first ways we tried to do

them back in the '70s and '80s

and '90s was to cut an antibody

just specific for a patient's

tumor.



RAZELLE KURZROCK, MD:

Now we have the tools

to precisely understand what's

wrong in each tumor.

And we can treat every patient

as an individual

with a customized treatment

for that patient.



MICHAEL POSTOW, MD: Targeted

therapy works usually by a pill,

sometimes

an intravenous infusion.

And before we give the patient

this type of treatment,

we need to test their tumor

to see what types

of either mutations

or abnormalities

that we could find in the tumor.



ALEXANDER DRILON, MD: And we

would take that sample

and take out the tumor's genes,

or the DNA,

and send that for testing.

The question then is, is there

a drug that's already approved

by the FDA?

And if there isn't, there may be

a drug on a clinical trial

that the patient might be

a candidate for.



PHILIP GREENBERG, MD:

Particularly for what we do,

which is about engineering

the immune system to work

against the patient's tumor,

it is highly personalized.

Because it really reflects

taking cells out of that person,

engineering those cells,

and putting them back.

There's very little that's more

personal than that.



ALEXANDER DRILON, MD: I think

targeted therapy is promising

because, one-- we've seen how

the therapies that we've already

developed have helped patients.

We've seen dramatic benefit,

dramatic responses

in select patients

with targeted treatment.



ALISON CAIRNES: I definitely

think targeted therapy saved

my life.

When I got the news

that the metastases seemed to be

gone, and they were just looking

at three little parts

in my liver, I kept waking up

and going,

I'm going to be cancer-free.

The targeted therapy is working.



MARK TOSE: In my generation,

if you've got acute leukemia,

that was pretty much it.

And now that's not the case.

There's a lot of hope.

I plan to be around

for a long time.



RAZELLE KURZROCK, MD: To me,

what the next three years is

going to bring is even more

sophisticated ways to match

patients to drugs.



MICHAEL POSTOW, MD: We are going

to see targeted therapy moving

to an area of even greater

specificity

for each individual patient.

We're going to see patients

with maybe three or four or five

different types of mutations

taking cocktails

of various different medications

intended to disable

multiple parts of that patient's

tumor.



So the greater specificity,

the greater individualism

of that person's

targeted therapy, I think

is going to be where we go.



[MUSIC PLAYING]

Michael A. Postow, MD<br>medical oncologist, Memorial Sloan Kettering Cancer Center<br>Razelle Kurzrock, MD<br>senior deputy center director, USCD Moores Cancer Center<br>Philip Greenberg, MD<br>head of program in immunology, Fred Hutchinson Cancer Research Center<br>David Maloney, MD, PhD<br>medical director of immunotherapy, Fred Hutchinson Cancer Research Center<br>Mark<br>acute myeloid leukemia survivor/delivery/e9/49/e94984e9-a5d9-412e-b9aa-bc486c0f2dce/vd-1161-uniquely-you–exploring-tailored-medicine_,750k,4500k,2500k,1000k,400k,.mp403/07/2018 12:00:00650350microscopic view of cell/webmd/consumer_assets/site_images/article_thumbnails/video/exploring_targeted_treatment_video/650x350_exploring_targeted_treatment_video.jpg091e9c5e8164f7b0

Most of the time, tailored medicine begins with a genetic test. This may involve a blood or saliva sample, or in the case of cancer, a biopsy of your tumor. Your doctor will also talk to you about your health history, your condition, and your possible treatments.

Continued

They also might:

  • Check your genes to decide if a medication will work for you
  • Test cells in your tumor to find out what kind of treatment to use to treat it
  • Do a genetic test to see if you have changes that make it more likely that you’ll get certain diseases

Tailored medicine isn’t just about genetics, though. Doctors can also use your individual and family health history, things in your lifestyle like diet and exercise habits, and your environment (for example, pollution levels near you) to decide on the right treatment for you.

Non-genetic information is also important for research that can lead to new treatments. For example, with many conditions, only some people with genetic changes linked to a disease actually get the disease. That could mean that things like where you live played a role in whether or not a gene was “turned on” and led to a disease.

Is It Right for You?

Tailored medicine is mostly used for people with advanced-stage cancers or conditions where there are few or no treatments, like rare childhood illnesses.

Continued

If you think tailored medicine might work for you, talk to your doctor about it. You can ask, “Would getting a genetic test help guide my choice of treatment?”

It’s also a good idea to discuss genetic testing if you have things that raise your chances of certain health conditions, like a family history of it. If your genes show your odds are higher than average, your doctor may suggest ways to make it less likely that you’ll get that disease.

If your doctor says tailored medicine or targeted treatment isn’t for you, standard medicines and treatments, like traditional chemotherapy for cancer, still work. And if one treatment doesn’t help, your medical team will keep working with you to find others.

 

Keep in mind that tailored medicine is still in its early stages. Medical centers and universities around the country are working to come up with new information that will help doctors pair the right patients with the right medications.

Continued

Today, many people have treatment options based on the particular substances in their tumors. They can get better, more specific treatments, which might also have fewer side effects.

That’s one of the major goals of personalized medicine: to give people who have cancer the treatments that are most likely to work in their specific cases with fewer harmful side effects.

WebMD Medical Reference

Sources

SOURCES:

The White House: "Fact Sheet: President Obama's Precision Medicine Initiative.”

National Institutes of Health/All of Us Research Program: "About the Precision Medicine Initiative," “Data and Research Center.”

American Cancer Society: “Personalized Medicine: Redefining Cancer and Its Treatment.”

Elizabeth A. McGlynn, PhD, vice president, Kaiser Permanente Research, Oakland, CA.

Milan Radovich, PhD, medical co-director, Indiana University/IU Health Precision Genomics Program, Indianapolis.

Eric Dishman, director, All of Us Research Program, National Institutes of Health.

NIH Genetics Home Reference: "Do all gene mutations affect health and development?"

University of Utah Genetic Science Learning Center: "More Examples of Precision Medicine in Action."

Stefan C. Grant, MD, associate professor, hematology & oncology, Wake Forest Baptist Medical Center, Winston-Salem, NC.

Intermountain Healthcare: "Talking to Your Doctor: Precision Medicine."

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