4.23. Goal for Personalized Medicine

4.23.1. Introduction of the Concept of Personalized Medicine
The mapping of the human genome and cataloguing of all the disease related polymorphisms are the major scientific milestones that have opened the door to new approaches to understand at molecular level and treat disease. Cancer and cardiovascular disease are two areas in which genomics are showing promise for treatment advances, although challenges remain. Among all other polymorphism, SNPs are the key enabler to realize the concept of personalize medicine. Personalized medicine is a term used in science and medicine that holds significant promise of improved disease treatment. Personalized medicine is holding out the promise of administering medicines explicitly tailored to a person’s specific genome or metabolism. Personalized medicine is the drugs that cure disease without adverse effects. “Personalized medicine” is now echoing across the health care sector, with the hope that genomic sciences will revolutionize the medical health care planning by individualizing and thereby optimizing it. Scientists, physicians and the pharmaceutical industry are actively developing ways to customize medical treatments to suit our unique genetic signatures. This emerging science is called personalized medicine.
Therefore, personalized medicine is the use of new methods of molecular analysis to better manage a patient’s disease or predisposition toward a particular disease. It aims to realize optimal medical outcomes by helping physicians and patients to choose the disease management approaches which can likely to work best in the context of the patient’s unique genetic and environmental profile. Such approaches may include genetic screening programs that more precisely diagnose diseases and their sub-types, or help physicians select the type and dose of medication best suited to a certain group of patients thereby minimize or nullifying the side effect.
Thus, in short personalized medicine can be defined as the use of information from a patient's genotype to:

• initiate a preventative measure against the development of a disease or condition, and
• select the most appropriate therapy for a disease or condition that is particularly suited to that patient.

FFigure 4.55: Drugs for future.

4.23.2. Genomic Variations/Biomarkers Are the Foundation of Personalized medicine

People vary from one another in many ways — what they eat, the types and amount of stress they experience, exposure to environmental factors. Therefore their DNA also varies. Many of these variations in DNA sequences play a role in health and disease. For example, the natural variations found in our genes could influence our risk of developing a certain disease, and the degree to which it progresses. Variations in several genes can influence a patient’s response to a particular drug medication. The completion of the Human Genome Project has set the stage to answer a number of questions like: What makes us similar and what makes us different both in physical appearance and in predisposition to a disease and in response to a particular drug medication?  Using the information of Hap Map project, researchers are now able to find genes that affect health and disease as well as individual responses to medications and environmental factors.

Figure 4.56: Right gene-Right Drug.

Thus, strong assurances and long term goals help in the long and painstaking job to unlock the mysteries of the human body. We now are grateful to the genomic researchers for the fact that there are between 30,000 and 40,000 protein-coding genes in the human genome, not the more than 1,00, 000 previously thought. From an evolutionary perspective, this represents only about twice as many as in the worm or fly genome. Genomics has yielded new molecular targets and therapeutic interventions in the world of cancer which have already been exploited, especially in patient selection, diagnosis and treatment. Genomics is also showing promise in cardiovascular, and many other diseases, with substantial challenges remaining. We are also better able to quantify the role of genes and genetic variation in disease and have learned that environmental influences are far more important than specific alterations in the genetic codes of common diseases. Scientists see SNPs as a potential tool to improve diseases DIAGNOSIS and TREATMENT planning. They suspect that SNPs may play a role in the different responses to treatments seen among cancer patients and they think that SNPs may also be involved in the different levels of individual cancer risk observed. Thus, genetic variations/SNPs are attractive target for better understanding the genetic basis of complex diseases, and to realize the PERSONALISED MEDICINE.

Personalized medicine hopes to use these variations to develop new safe and effective treatment planning for genetically defined sub-groups of patients. Treatments may include administration of drug therapy as well as recommendations for lifestyle changes that can delay onset of a disease or reduce its impact.