The overwhelming complexity involved in unravelling of the genetic lesions behind the development of CLL and its progression will be familiar to regular readers of the more technical posts. The US President in his State of Union address included a promise to fund a new “precision medicine initiative”. "Precision medicine describes a new approach to the prevention, diagnosis and treatment of diseases. It helps deliver treatment based on the particular variant of the disease by taking the genetic make-up of the ill person into account."
But it will take a while :
Hypotheses need to be posed and tested through big longitudinal studies involving many people before meaningful insights can be made and translated into diagnostic tests, treatments and preventive strategies."
And prove very expensive without significant breakthroughs:
"But precision medicine is designed to develop treatments for smaller numbers of people. Not only does this mean a smaller market across which the cost of drug development needs to be spread, it also means governments may be less likely to offer subsidies. A single year’s supply for the cystic fibrosis drug mentioned above, for instance, currently costs more than US$300,000, making it one of the most expensive drugs available in America."
More on the promises and challenges of Precision Medicine from Ingrid Winship, Professor of Genetics and Executive Director of Research at Melbourne Health and Timothy Smith, Honorary Fellow, Department of Pathology at University of Melbourne:
The included example of the genetics behind the development and treatment of Cystic Fibrosis makes you appreciate the enormity of the challenges involved when you consider all the different cancers and diseases with a genetic basis. That US funding will need to seed the development of some powerful automation technology, along the lines we've already seen with genome sequencing, to significantly help with delivery of the promise held out by precision medicine.
Photo: Crab apple blossom